Healthcare Provider Details

I. General information

NPI: 1821724626
Provider Name (Legal Business Name): MICHELLE CONCEPCION
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2022
Last Update Date: 02/06/2026
Certification Date: 02/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34200 ALVARADO NILES RD
UNION CITY CA
94587-4402
US

IV. Provider business mailing address

39660 POTRERO DR
NEWARK CA
94560-5613
US

V. Phone/Fax

Practice location:
  • Phone: 510-471-1100
  • Fax: 510-471-0262
Mailing address:
  • Phone: 510-861-0551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95035888
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code364SC1501X
TaxonomyCommunity Health/Public Health Clinical Nurse Specialist
License Number54336
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number512035
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: