Provider Demographics
NPI:1306730544
Name:BRUNO, GRACE ANNE (CMT)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:ANNE
Last Name:BRUNO
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 CALIFORNIA AVE APT 507
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-5031
Mailing Address - Country:US
Mailing Address - Phone:310-428-0579
Mailing Address - Fax:
Practice Address - Street 1:330 CALIFORNIA AVE APT 507
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-5031
Practice Address - Country:US
Practice Address - Phone:310-428-0579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty