Provider Demographics
NPI:1578527842
Name:COBBS, YVONNE CARLISA (DNP, ANP-C, PHN RN)
Entity Type:Individual
Prefix:DR
First Name:YVONNE
Middle Name:CARLISA
Last Name:COBBS
Suffix:
Gender:F
Credentials:DNP, ANP-C, PHN RN
Other - Prefix:MS
Other - First Name:YVONNE
Other - Middle Name:CARLISA
Other - Last Name:VIGAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANP-C, PHN, RN
Mailing Address - Street 1:1063 SAN PABLO AVE STE B
Mailing Address - Street 2:
Mailing Address - City:PINOLE
Mailing Address - State:CA
Mailing Address - Zip Code:94564-2473
Mailing Address - Country:US
Mailing Address - Phone:510-964-9275
Mailing Address - Fax:188-880-4334
Practice Address - Street 1:1063 SAN PABLO AVE
Practice Address - Street 2:SUITE B
Practice Address - City:PINOLE
Practice Address - State:CA
Practice Address - Zip Code:94564-2346
Practice Address - Country:US
Practice Address - Phone:510-964-9275
Practice Address - Fax:888-804-1432
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11980363LP2300X, 363LA2200X, 363LC1500X, 363LP0808X
CA508156163WP0809X
CANP11980363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health