Individual provider Active NPI

Tadesse Worku

  • Nurse Practitioner
  • Orange, CA
National Provider Identifier
1831989631
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP95029959 Issued in CA
Practice address
1100 W Town and Country Rd Ste 1600
Orange, CA 92868-4698
Phone
(844) 310-2247
NPI assigned
May 7, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP95029959 CA Primary
Family Nurse Practitioner 363LF0000X NP95029959 CA

Addresses

Primary practice location

1100 W Town and Country Rd Ste 1600
Orange, CA 92868-4698

Mailing address

3501 S Bascom Ave Apt 1
Campbell, CA 95008-7051
Phone (571) 723-1401

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
NP95029959CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1746576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1831989631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 S BASCOM AVE APT 1",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950087051",
            "telephone_number": "571-723-1401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 W TOWN AND COUNTRY RD STE 1600",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684698",
            "telephone_number": "844-310-2247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORKU",
        "first_name": "TADESSE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-07",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP95029959",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95029959",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.