Organization · NPI-2

Alta Vida Psychiatry, PLLC

Clinic/Center, Mental Health (Including Community Mental Health Center) · Tempe, AZ

NPI number1316847122
StatusActive
Last updated in NPPESNov 6, 2026

Details

NPI
1316847122
Entity type
Organization (NPI-2)
Legal business name
Alta Vida Psychiatry, PLLC
Organization subpart
No
Enumeration date
Nov 6, 2026
Certification date
Nov 6, 2026
Last updated
Nov 6, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)––Yes

Practice location

2525 S Rural Rd Ste 4n
Tempe, AZ 85282-2442

Phone 480-499-0102 · Fax 480-499-0295

Mailing address

3290 E Mayberry Ave
Gilbert, AZ 85297-8251

Phone 480-274-5691

Authorized official

Marion Crisostomo
Pmhnp-Bc
4802745691

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