NPIMap

Organization Active NPI

Bonita House, Inc.

  • Case Management Agency
  • Berkeley, CA
National Provider Identifier
1528080553
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
BONITA HOUSE, INC.
Practice address
1410 Bonita Ave
Berkeley, CA 94709-1909
Phone
(510) 899-7445
Fax
(510) 647-9408
NPI assigned
Jul 25, 2006
Reactivated
May 2, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X CA Primary
Mental Illness Community Based Residential Treatment Facility 320800000X 011400072 CA

Addresses

Primary practice location

1410 Bonita Ave
Berkeley, CA 94709-1909

Mailing address

2640 Martin Luther King Jr Way
Berkeley, CA 94704-3238
Phone (510) 714-0996

National Provider Directory

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

Other organizations with this tax ID 8

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

Locations

1410 Bonita Ave
Berkeley, CA 94709
Phone (510) 526-4765

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722556800000",
    "number": "1528080553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 MARTIN LUTHER KING JR WAY",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947043238",
            "telephone_number": "510-714-0996",
            "fax_number": "510-647-9408"
        },
        {
            "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": "510-899-7445",
            "fax_number": "510-647-9408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONITA HOUSE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "deactivation_date": "2023-03-17",
        "reactivation_date": "2023-05-02",
        "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": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "CA",
            "license": "011400072",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.