Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Olivfaun Stallworth

Individual provider Licensed Vocational Nurse · NPI 1104624477

Olivfaun Stallworth is a Licensed Vocational Nurse in Los Angeles, California. Licensed in California. Registered with an NPI since 2025.

Licensed in
CA
In the registry since
2025

Practice location Address checks out

12021 Wilmington Ave Ste 2B
Los Angeles, CA 90059-3019
Phone: (310) 221-6336
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Licensed Vocational Nurse (primary) Taxonomy 164X00000X · Licence 198805 (CA)

Record details

NPI number1104624477
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 4, 2025
Last updated in NPPESMarch 4, 2025
Certification dateMarch 4, 2025

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