Provider Demographics
NPI:1497337711
Name:COLIBRI FAMILY THERAPY SERVICES, INC
Entity Type:Organization
Organization Name:COLIBRI FAMILY THERAPY SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:562-673-2683
Mailing Address - Street 1:11110 LOS ALAMITOS BLVD STE 211
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-3602
Mailing Address - Country:US
Mailing Address - Phone:562-673-2683
Mailing Address - Fax:
Practice Address - Street 1:11110 LOS ALAMITOS BLVD STE 211
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3602
Practice Address - Country:US
Practice Address - Phone:562-673-2683
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-26
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty