Stork Club Fertility, Inc.

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

STORK CLUB FERTILITY, INC.

Practice address

1 Bluxome Street
Suite 203
San Francisco, CA 94107-5518

Phone

(415) 801-0467

Fax

(415) 801-0467

NPI assigned

Apr 16, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Miss Jeni Mayorskaya

Title

Chief Executive Officer

Phone

(415) 801-0467

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555372800000",
    "number": "1962065904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BLUXOME STREET",
            "address_2": "SUITE 203",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941075518",
            "telephone_number": "415-801-0467",
            "fax_number": "415-801-0467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BLUXOME STREET",
            "address_2": "SUITE 203",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941075518",
            "telephone_number": "415-801-0467",
            "fax_number": "415-801-0467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STORK CLUB FERTILITY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-16",
        "last_updated": "2019-04-16",
        "status": "A",
        "authorized_official_last_name": "MAYORSKAYA",
        "authorized_official_first_name": "JENI",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "415-801-0467",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stonestown Pediatrics
• Stonewall Project, UCSF
• Mont Stong, AU.D.
• Matthew Stoops, RN
• Dora Anna Rendulic Storelli, MD
• Christine M Storm, P.T.
• James Eugene Storm, M.D.
• Jason R Storm
• Tristan Storm
• Victoria Rae Storr, LMFT

• Exclusive Provider Organization in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Exclusive Provider Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.