Provider Demographics
NPI:1881565976
Name:CONCEPCION GONZALEZ, CHRISTIAN J
Entity type:Individual
Prefix:MR
First Name:CHRISTIAN
Middle Name:J
Last Name:CONCEPCION GONZALEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 KINGS HWY
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02745-4901
Mailing Address - Country:US
Mailing Address - Phone:508-329-9819
Mailing Address - Fax:
Practice Address - Street 1:500 KINGS HWY
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02745-4901
Practice Address - Country:US
Practice Address - Phone:508-329-9819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-13
Last Update Date:2025-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty