BONITA HOUSE, INC. (NPI# 1235344912) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235344912 |
| Entity Type | Organization |
| Organization Name | BONITA HOUSE, INC. |
| Practice Address |
1410 Bonita Ave Berkeley CA 94709-1909 |
| Mailing Address |
6333 Telegraph Ave Suite 102 Oakland CA 94609-1359 |
| Practice Telephone | 5105264765 |
| Mailing Telephone | 5109231099 |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2011-03-09 |
| Authorized Official Name | RICK R CRISPINO (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5109231099 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | 81492 | CA | Agencies |
| Y | 251S00000X | Community/Behavioral Health | 81491 | CA | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 81491 | 05 | |
| CA | 81492 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811559735 | Bonita House, Inc. | Community/Behavioral Health | 1909 University Ave, Berkeley, CA 94704 | 2019-07-01 |
| 1396950085 | Bonita House, Inc. | Community/Behavioral Health | 1802 Fairview St, Berkeley, CA 94703-2414 | 2007-05-14 |
| 1073728770 | Bonita House, Inc. | Case Management | 6333 Telegraph Ave Ste 102, Oakland, CA 94609-1359 | 2007-05-14 |
| 1902253016 | Bonita House, Inc. | Community/Behavioral Health | 7200 Bancroft Ave, Suite 267, Oakland, CA 94605-2403 | 2016-05-18 |
| 1053526715 | Bonita House, Inc. | Case Management | 1422 Harrison St, Oakland, CA 94612-3903 | 2007-05-14 |
| 1760697312 | Bonita House, Inc. | Community/Behavioral Health | 1410 Bonita Ave, Berkeley, CA 94709-1909 | 2007-05-14 |
| 1528080553 | Bonita House, Inc. | Case Management | 6333 Telegraph Ave, Suite 102, Oakland, CA 94609-1359 | 2006-07-25 |
| Street Address |
1410 BONITA AVE |
| City | BERKELEY |
| State | CA |
| Zip Code | 94709-1909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235264904 | Ralph V Pericoli | Specialist | 1410 Bonita Ave, Berkeley, CA 94709-1909 | 2007-02-22 |
| 1649814252 | Anna Moore | Social Worker | 1410 Bonita Ave, Berkeley, CA 94709-1909 | 2019-11-06 |
| 1699280974 | Claire Costello | Counselor | 1410 Bonita Ave, Berkeley, CA 94709-1909 | 2017-12-07 |
| 1043720998 | Kristen Portney | Psychologist | 1410 Bonita Ave, Berkeley, CA 94709-1909 | 2017-10-05 |
| 1760697312 | Bonita House, Inc. | Community/Behavioral Health | 1410 Bonita Ave, Berkeley, CA 94709-1909 | 2007-05-14 |
| 1497883458 | Jessica C Ramirez | Specialist | 1410 Bonita Ave, Berkeley, CA 94709-1909 | 2007-03-01 |
| 1356476931 | Lora Powell | Specialist | 1410 Bonita Ave, Berkeley, CA 94709-1909 | 2007-02-22 |
| 1174658843 | John B Elford | Specialist | 1410 Bonita Ave, Berkeley, CA 94709-1909 | 2007-02-22 |
| 1568597144 | Katharyne L Robinson | Specialist | 1410 Bonita Ave, Berkeley, CA 94709-1909 | 2007-02-22 |
| 1568597136 | Iona M Madplume | Specialist | 1410 Bonita Ave, Berkeley, CA 94709-1909 | 2007-02-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144868647 | Komalpreet Kaur | Pharmacist | 1444 Shattuck Place, Berkeley, CA 94709 | 2019-12-16 |
| 1689189763 | Lynn Rubin | Marriage & Family Therapist | 1524 Henry St., Berkeley, CA 94709 | 2017-12-11 |
| 1750825154 | Stacy Taniguchi | Psychologist | 2000 Hearst Ave Ste 207, Berkeley, CA 94709 | 2016-12-05 |
| 1558804708 | Tylynn Ludwig | Dietitian, Registered | 1525 Shattuck Ave Ste G, Berkeley, CA 94709 | 2016-11-21 |
| 1528316171 | Leeat Zwick-louvton | Physical Therapist | 2209 Glen Ave, Berkeley, CA 94709 | 2012-08-29 |
| 1497016588 | City of Berkeley | Case Management | 1901 Hearst Street, Berkeley, CA 94709 | 2012-06-05 |
| 1841591914 | Dana Carr | Psychologist | 1078 Shattuck Avenue, #6, Berkeley, CA 94709 | 2010-11-05 |
| 1568639565 | Harry Joseph Lieberman | Marriage & Family Therapist | 1933 Rose St, Berkeley, CA 94709 | 2008-05-09 |
| 1780806935 | Martha W Knobler | Marriage & Family Therapist | 2045 Francisco Street, Berkeley, CA 94709 | 2007-05-03 |
| 1578690830 | Alice H Brown | Counselor | 1607 Walnut Street # One, Berkeley, CA 94709 | 2007-02-27 |
| Find all providers in zip 94709 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104435023 | Shuni Inc | Community/Behavioral Health | 2120 University Ave, Berkeley, CA 94704-1026 | 2020-07-27 |
| 1811559735 | Bonita House, Inc. | Community/Behavioral Health | 1909 University Ave, Berkeley, CA 94704 | 2019-07-01 |
| 1396205068 | Supportiv | Community/Behavioral Health | 2222 Harold Way, Berkeley, CA 94704-1425 | 2019-03-20 |
| 1336628338 | Satellite Affordable Housing Associates | Community/Behavioral Health | 3240 Sacramento St, Berkeley, CA 94702-2740 | 2018-08-09 |
| 1831602457 | Options Recovery Services | Community/Behavioral Health | 3331 King St, Berkeley, CA 94703-2647 | 2017-11-06 |
| 1497268072 | Options Recovery Services | Community/Behavioral Health | 1845 Addison St, Berkeley, CA 94703-1503 | 2017-11-06 |
| 1124557046 | New Bridge Foundation, Inc. | Community/Behavioral Health | 2425 Stuart St, Berkeley, CA 94705-1115 | 2017-06-05 |
| 1205362811 | County of Alameda | Community/Behavioral Health | 2015 Virginia St Rm 102, Berkeley, CA 94709-2229 | 2017-05-03 |
| 1144687435 | Ste Consultants | Community/Behavioral Health | 2560 9th St Ste 220, Berkeley, CA 94710-2565 | 2016-01-19 |
| 1144628363 | Berkeley Addiction Treatment Services | Community/Behavioral Health | 2798 Sacramento St, Berkeley, CA 94702-2337 | 2014-12-22 |
| Find all providers in BERKELEY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.