Provider Demographics
NPI:1447547302
Name:JONELIS, MICHELLE BINDER (MD)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:BINDER
Last Name:JONELIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:775 E BLITHEDALE AVE # 615
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-1554
Mailing Address - Country:US
Mailing Address - Phone:415-226-9389
Mailing Address - Fax:415-728-9764
Practice Address - Street 1:100 SHORELINE HWY STE 100
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-3645
Practice Address - Country:US
Practice Address - Phone:415-226-9389
Practice Address - Fax:415-728-9764
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1182882084S0012X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine