Provider Demographics
NPI:1689861007
Name:VILLA, FILOMENA HAZEL ROCHA (MD)
Entity Type:Individual
Prefix:DR
First Name:FILOMENA HAZEL
Middle Name:ROCHA
Last Name:VILLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:HAZEL
Other - Middle Name:ROCHA
Other - Last Name:VILLA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:9300 VALLEY CHILDRENS PL # SC05
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93636-8761
Mailing Address - Country:US
Mailing Address - Phone:559-353-5700
Mailing Address - Fax:
Practice Address - Street 1:9300 VALLEY CHILDRENS PL
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93636-8761
Practice Address - Country:US
Practice Address - Phone:559-353-3000
Practice Address - Fax:559-353-5708
Is Sole Proprietor?:No
Enumeration Date:2007-09-30
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP34782080P0214X
CAA1078132080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX300915101Medicaid
TX300915102OtherCSHCN
TXTXB155521Medicare PIN