MEDICARE: DR. YVONNE CARLISA COBBS DNP, ANP-C, PHN. RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner	11980	CA
2	163WP0809X	Adult Psychiatric/Mental Health Registered Nurse	508156	CA
3	363LA2200X	Adult Health Nurse Practitioner	NP11980	CA
4	363LA2200X	Adult Health Nurse Practitioner	11980	CA
5	363LC1500X	Community Health Nurse Practitioner	11980	CA
6	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	11980	CA

General Provider Information

NPI Number	:	1578527842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YVONNE CARLISA COBBS DNP, ANP-C, PHN. RN

Provider Business Mailing Address
First Line	:	1063 SAN PABLO AVE STE B
Second Line	:
City	:	PINOLE
State	:	CA
Zip	:	94564-2473
Country	:	US
Telephone Number	:	510-964-9275
Fax Number	:	188-880-4334

Provider Business Practice Location Address
First Line	:	1063 SAN PABLO AVE
Second Line	:	SUITE B
City	:	PINOLE
State	:	CA
Zip	:	94564-2346
Country	:	US
Telephone Number	:	510-964-9275
Fax Number	:	888-804-1432

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2006
Last Update Date	:	02/12/2021

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