Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Adin Samuel Vaewsorn, RN, PMHNP

Individual provider Registered Nurse · NPI 1932719192

Adin Samuel Vaewsorn, RN, PMHNP is a Nurse Practitioner in Oakland, California. Qualified in 2021, 5 years ago. Practices with Bonita House, Inc, a 2-clinician group, works from 2 locations and offers telehealth. Licensed in California.

Years since qualifying
5
Licensed in
CA
In the registry since
2020
Specialties on file
2
What do these letters mean?
RN — Registered Nurse
A licensed nurse who completed a nursing degree and passed the NCLEX-RN examination.
PMHNP — Psychiatric-Mental Health Nurse Practitioner
A nurse practitioner specialising in mental health, able to prescribe psychiatric medication.

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Practice location Address checks out

1501 Fruitvale Ave
Oakland, CA 94601-2322
Phone: (510) 635-5200
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1605 Jefferson St, Oakland, CA 94612-1215 — (510) 923-1099

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 95018370 (CA)
Registered Nurse Taxonomy 163W00000X · Licence 95204521 (CA)

Record details

NPI number1932719192
Entity typeIndividual (Type 1)
GenderMale
Credentials RN , PMHNP
Sole proprietorNo
NPI enumeratedAugust 3, 2020
Last updated in NPPESMarch 19, 2025
Certification dateMarch 19, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Bonita House, Inc. — 2 clinicians
Accepts Medicare assignment Not indicated
TelehealthOffers telehealth services

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