MEDICARE: CLAUDELL STEPHENS MD AND YVONNE COBBS NP MEDICAL PRACTICES

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	NP11980	CA
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	NP11980	CA
3	261QH0100X	Health Service Clinic/Center	G34895	CA

General Provider Information

NPI Number	:	1609111830
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLAUDELL STEPHENS MD AND YVONNE COBBS NP MEDICAL PRACTICES

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	:	888-804-1432

Provider Business Practice Location 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	:	888-804-1432

Authorized Official
Title or Position	:	PARTNER
Name	:	MS. YVONNE CARLISA COBBS
Credential	:	RN, PHN, ANP-C
Telephone Number	:	510-964-9275

Provider Enumeration Date	:	11/28/2012
Last Update Date	:	06/27/2016

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