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OLIVFAUN STALLWORTH
NPI 1104624477
Licensed Vocational Nurse in Los Angeles, CA

Active since March 04, 2025
12021 WILMINGTON AVE STE 2B, LOS ANGELES, CA 90059(310) 221-6336 Get Directions Write a Review

NPPES record last updated: March 4, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Olivfaun Stallworth NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OLIVFAUN STALLWORTH (NPI 1104624477) is an individual licensed vocational nurse in Los Angeles, California, licensed in California (198805) and active in the NPI registry since March 2025.

NPPES Registry Identity

NPI1104624477
Entity TypeIndividualMale
Primary Taxonomy164X00000X
Provider Legal NameOLIVFAUN STALLWORTH
Location Address12021 WILMINGTON AVE STE 2BLos Angeles, CA 90059-3019
Mailing Address12021 Wilmington Ave Ste 2bLos Angeles, CA 90059-3019 · (310) 221-6336
Phone(310) 221-6336
Sole ProprietorNo
Enumeration DateMarch 4, 2025
NPPES CertifiedMarch 4, 2025
✔ NPI 1104624477 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Vocational NurseNursing Service Providers
Taxonomy Code164X00000X
License✔ Licensed in CA · 198805
Definition
A licensed vocational nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. [An alternate term for licensed practical nurse arising from difference in occupational titles between states and post-high school training programs and institutions.] Requirements for education, experience, licensure, and job responsibilities vary among the states.
12021 WILMINGTON AVE STE 2B, Los Angeles, CA 90059
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NATALIA MALDONADO
Day Training/Habilitation Specialist
12021 WILMINGTON AVE STE 2B
LOS ANGELES, CA 90059
Los Angeles County (213) 222-1681
ISAIAH CHRISTOPHER LORING
Day Training/Habilitation Specialist
12021 WILMINGTON AVE STE 2B
LOS ANGELES, CA 90059
Los Angeles County (310) 221-6336
I'NESA MAE JOHNSON
Day Training/Habilitation Specialist
12021 WILMINGTON AVE STE 2B
LOS ANGELES, CA 90059
Los Angeles County (310) 221-6336
SHIELLA MAE BEL
Licensed Vocational Nurse
12021 WILMINGTON AVE STE 2B
LOS ANGELES, CA 90059
Los Angeles County (213) 222-1681
BENITA MONIQUE CANDO
Day Training/Habilitation Specialist
12021 WILMINGTON AVE STE 2B
LOS ANGELES, CA 90059
Los Angeles County (213) 222-1681
HAYLEY COOPER
Community Health Worker
12021 WILMINGTON AVE STE 2B
LOS ANGELES, CA 90059
Los Angeles County (310) 221-6336
KELLI DAVIS
Licensed Vocational Nurse
12021 WILMINGTON AVE STE 2B
LOS ANGELES, CA 90059
Los Angeles County (213) 222-1681
MICHEAL HODGES
Community Health Worker
12021 WILMINGTON AVE STE 2B
LOS ANGELES, CA 90059
Los Angeles County (310) 221-6336

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Olivfaun Stallworth's NPI number?

The NPI number for Olivfaun Stallworth is 1104624477. It was assigned to this individual provider in the NPPES registry on March 4, 2025.

Where is Olivfaun Stallworth located?

Olivfaun Stallworth practices at 12021 Wilmington Ave Ste 2B, Los Angeles, CA 90059. The listed phone number is (310) 221-6336.

What is Olivfaun Stallworth's specialty?

The primary specialty registered for this NPI is Licensed Vocational Nurse with taxonomy code 164X00000X.

When was this NPI record last updated?

The NPPES record for Olivfaun Stallworth was last updated on March 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.