Healthcare Provider Details

I. General information

NPI: 1114856754
Provider Name (Legal Business Name): MICHELE MARIE BOND MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1424 4TH ST STE 236
SANTA MONICA CA
90401-3444
US

IV. Provider business mailing address

5840 BOWCROFT ST UNIT 4
LOS ANGELES CA
90016-4925
US

V. Phone/Fax

Practice location:
  • Phone: 310-720-7257
  • Fax:
Mailing address:
  • Phone: 310-720-7257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: