Provider Demographics
NPI:1780909044
Name:MOZAKO-VILLA, RODREY ANNE
Entity type:Individual
Prefix:MRS
First Name:RODREY
Middle Name:ANNE
Last Name:MOZAKO-VILLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 WEST GONZALEZ ROAD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-0729
Mailing Address - Country:US
Mailing Address - Phone:805-983-3557
Mailing Address - Fax:805-983-2337
Practice Address - Street 1:451 WEST GONZALEZ ROAD
Practice Address - Street 2:SUITE 260
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-0729
Practice Address - Country:US
Practice Address - Phone:805-983-3557
Practice Address - Fax:805-983-2337
Is Sole Proprietor?:No
Enumeration Date:2010-03-30
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11809363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner