Provider Demographics
NPI:1881927184
Name:BOND, ALAN
Entity type:Individual
Prefix:MR
First Name:ALAN
Middle Name:
Last Name:BOND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3909 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-3410
Mailing Address - Country:US
Mailing Address - Phone:619-692-2077
Mailing Address - Fax:619-718-6447
Practice Address - Street 1:3909 CENTRE ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-3410
Practice Address - Country:US
Practice Address - Phone:619-692-2077
Practice Address - Fax:619-718-6447
Is Sole Proprietor?:No
Enumeration Date:2009-09-17
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
CA25805103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor