| Bonita House Inc | |
|
13939 E 14th St Ste 190 San Leandro CA 94578-2601 | |
| (510) 899-7445 | |
| (510) 647-9408 |
| Full Name | Bonita House Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 13939 E 14th St Ste 190, San Leandro, California |
| Authorized Official Name and Position | Laura Evon Weissberger (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5105931950 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bonita House Inc 1919 Addison St Ste 204 Berkeley CA 94704-1143 Ph: (510) 899-7445 | Bonita House Inc 13939 E 14th St Ste 190 San Leandro CA 94578-2601 Ph: (510) 899-7445 |
| NPI Number | 1912618794 |
|---|---|
| Provider Enumeration Date | 12/12/2022 |
| Last Update Date | 08/26/2023 |
| Certification Date | 08/26/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912618794 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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