Healthcare Provider Details

I. General information

NPI: 1982179081
Provider Name (Legal Business Name): STARCHILD INTERVENTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2018
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11500 W OLYMPIC BLVD STE 400
LOS ANGELES CA
90064-1525
US

IV. Provider business mailing address

11500 W OLYMPIC BLVD STE 400
LOS ANGELES CA
90064-1525
US

V. Phone/Fax

Practice location:
  • Phone: 818-540-5802
  • Fax:
Mailing address:
  • Phone: 818-540-5802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: SEAN RANEL
Title or Position: CTO
Credential:
Phone: 630-886-7411