MEDICARE: CIRCLE PIT WELLNESS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133NN1002X	Nutrition Education Nutritionist
2	171400000X	Health & Wellness Coach

General Provider Information

NPI Number	:	1811859325
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CIRCLE PIT WELLNESS LLC

Provider Business Mailing Address
First Line	:	929 COLORADO AVE # 301
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90401-2716
Country	:	US
Telephone Number	:	424-265-7785
Fax Number	:

Provider Business Practice Location Address
First Line	:	929 COLORADO AVE # 301
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90401-2716
Country	:	US
Telephone Number	:	424-265-7785
Fax Number	:

Authorized Official
Title or Position	:	HEALTH AND WELLNESS COACH
Name	:	KATRINA HANNER
Credential	:	MA
Telephone Number	:	424-265-7785

Provider Enumeration Date	:	12/02/2025
Last Update Date	:	12/02/2025

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Directions to “CIRCLE PIT WELLNESS LLC ” Practice Location

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