Healthcare Provider Details

I. General information

NPI: 1073424107
Provider Name (Legal Business Name): MADISYN ROCHA M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 PLEASANT AVE
WINDSOR CA
95492
US

IV. Provider business mailing address

2950 BAY VILLAGE CIR APT 1070
SANTA ROSA CA
95403-2287
US

V. Phone/Fax

Practice location:
  • Phone: 707-657-5022
  • Fax:
Mailing address:
  • Phone: 707-499-3154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: