Healthcare Provider Details

I. General information

NPI: 1407782113
Provider Name (Legal Business Name): HEALTHY LIVING CLINIC, A NURSING CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1063 SAN PABLO AVE STE B
PINOLE CA
94564-2473
US

IV. Provider business mailing address

1063 SAN PABLO AVE STE B
PINOLE CA
94564-2473
US

V. Phone/Fax

Practice location:
  • Phone: 510-964-9275
  • Fax: 888-804-1432
Mailing address:
  • Phone: 510-964-9275
  • Fax: 888-804-1432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. YVONNE COBBS
Title or Position: CEO
Credential: DNP, ANP-C
Phone: 510-964-9275