NPIMap

Organization Active NPI

Bonita House, Inc.

Doing business as Residential Program

  • Community/Behavioral Health Agency
  • Berkeley, CA
National Provider Identifier
1235344912
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
81492 Issued in CA
Legal business name
BONITA HOUSE, INC.
Doing business as
Residential Program
Practice address
1410 Bonita Ave
Berkeley, CA 94709-1909
Phone
(510) 526-4765
Fax
(510) 526-2887
NPI assigned
May 14, 2007
Reactivated
Jul 24, 2023
Organization subpart
Yes
Parent organization
BONITA HOUSE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

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

Authorized official

Name
Laura Evon Weissberger
Title
Executive Director
Phone
(510) 593-1950

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 81491 CA
Community/Behavioral Health Agency 251S00000X 81492 CA Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

1410 Bonita Ave
Berkeley, CA 94709-1909

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
81493MedicaidCA
81491MedicaidCA
81492MedicaidCA

Other names 1

  • Residential Program 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
This NPI is an additional NPI on the 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.

Locations

150 Grand Ave
Ste 200
Oakland, CA 94612

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1782345600000",
    "number": "1235344912",
    "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": "1410 BONITA AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947091909",
            "telephone_number": "510-526-4765",
            "fax_number": "510-526-2887"
        }
    ],
    "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": "2026-06-25",
        "certification_date": "2026-06-25",
        "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": "510-593-1950"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "81491",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "81492",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "81493",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "81491",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "81492",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Residential Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.