Provider Demographics
NPI:1588166375
Name:LATHOS, ALEXANDRA LAUREN (MSN, APRN,FNP-C, ATC)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:LAUREN
Last Name:LATHOS
Suffix:
Gender:F
Credentials:MSN, APRN,FNP-C, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:27116 PRESTANCIA WAY
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93908-1556
Mailing Address - Country:US
Mailing Address - Phone:831-809-3166
Mailing Address - Fax:
Practice Address - Street 1:23 UPPER RAGSDALE DR STE 200
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-7849
Practice Address - Country:US
Practice Address - Phone:831-375-3577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-07
Last Update Date:2025-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2255A2300X
CA95035473363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer