Healthcare Provider Details

I. General information

NPI: 1578527842
Provider Name (Legal Business Name): YVONNE CARLISA COBBS DNP, ANP-C, PHN. RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: YVONNE CARLISA VIGAY ANP-C, PHN, RN

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 02/12/2021
Certification Date: 02/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1063 SAN PABLO AVE SUITE B
PINOLE CA
94564-2346
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: 188-880-4334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number11980
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number508156
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberNP11980
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number11980
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License Number11980
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11980
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: