NPIMap

Organization Active NPI

Bonita House, Inc.

Doing business as Supported Independent Living

  • Case Management Agency
  • Oakland, CA
National Provider Identifier
1073728770
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
01113 Issued in CA
Legal business name
BONITA HOUSE, INC.
Doing business as
Supported Independent Living
Practice address
150 Grand Ave Ste 200
Oakland, CA 94612-3726
Phone
(510) 923-1099
NPI assigned
May 14, 2007
Reactivated
Jul 24, 2023
Last updated
Sep 1, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
BONITA HOUSE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Laura Evon Weissberger, LCSWNPI 1184027229
Title
Executive Director
Phone
(661) 993-9053

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 01113 CA Primary

Addresses

Primary practice location

150 Grand Ave Ste 200
Oakland, CA 94612-3726

Mailing address

150 Grand Ave Ste 200
Oakland, CA 94612-3726
Phone (510) 923-1099

Other identifiers 1

IdentifierTypeStateIssuer
01113MedicaidCA

Other names 1

  • Supported Independent Living Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110110000671 CA Part B Supplier - Clinic/Group Practice 1153510953 Receives reassigned benefits from 8 practitioners
5 other NPIs on this enrollment
Practice locations: Berkeley, CA; Oakland, CA

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Bonita House Inc9 organizations share this tax ID, including this one
Part of
Bonita House Inc

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788220800000",
    "number": "1073728770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 GRAND AVE STE 200",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946123726",
            "telephone_number": "510-923-1099",
            "fax_number": "510-923-0894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 GRAND AVE STE 200",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946123726",
            "telephone_number": "510-923-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONITA HOUSE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BONITA HOUSE INC",
        "enumeration_date": "2007-05-14",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "deactivation_date": "2023-03-17",
        "reactivation_date": "2023-07-24",
        "status": "A",
        "authorized_official_last_name": "WEISSBERGER",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "EVON",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "661-993-9053",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "CA",
            "license": "01113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01113",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Supported Independent Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.