Healthcare Provider Details

I. General information

NPI: 1124992037
Provider Name (Legal Business Name): STARFISH STORIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2025
Last Update Date: 10/02/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1224 W 40TH PLACE
LOS ANGLES CA
90037
US

IV. Provider business mailing address

P.O. BOX 7190
LOS ANGELES CA
90007
US

V. Phone/Fax

Practice location:
  • Phone: 323-293-1111
  • Fax: 866-639-1851
Mailing address:
  • Phone: 323-293-1111
  • Fax: 866-639-1851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: TERESA LOPEZ-DELLAMARY GROTH
Title or Position: EXECUTIVE DIRECTOR/CEO
Credential:
Phone: 323-293-1111