Individual provider Active NPI

Meron Tsegaye Hordofa

  • Licensed Vocational Nurse
  • Redwood City, CA
National Provider Identifier
1619846722
Registry record updated Nov 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
753599 Issued in CA
Practice address
200 Edmonds Rd
Redwood City, CA 94062-3813
Phone
(650) 367-1890
NPI assigned
Nov 5, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 753599 CA Primary

Addresses

Primary practice location

200 Edmonds Rd
Redwood City, CA 94062-3813

Mailing address

1120 Arguello St Apt 9
Redwood City, CA 94063-1235
Phone (408) 509-5729

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
753599CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1762300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1619846722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 ARGUELLO ST APT 9",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940631235",
            "telephone_number": "408-509-5729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 EDMONDS RD",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940623813",
            "telephone_number": "650-367-1890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORDOFA",
        "first_name": "MERON",
        "middle_name": "TSEGAYE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-05",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "753599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redwood City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2025; 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.