Healthcare Provider Details

I. General information

NPI: 1619823846
Provider Name (Legal Business Name): COLIBRI VISTAS MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2026
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26311 S 194TH ST
QUEEN CREEK AZ
85142-5848
US

IV. Provider business mailing address

24871 S ELLSWORTH RD STE 100-162
QUEEN CREEK AZ
85142-1574
US

V. Phone/Fax

Practice location:
  • Phone: 480-269-4106
  • Fax: 928-264-9841
Mailing address:
  • Phone: 480-269-4106
  • Fax: 928-264-9841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: TERESA ROBINSON
Title or Position: OWNER/MEMBER
Credential: PMHNP
Phone: 480-861-7784