Healthcare Provider Details

I. General information

NPI: 1588166375
Provider Name (Legal Business Name): ALEXANDRA LAUREN LATHOS MSN, APRN,FNP-C, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2018
Last Update Date: 06/07/2025
Certification Date: 06/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 UPPER RAGSDALE DR STE 200
MONTEREY CA
93940-7849
US

IV. Provider business mailing address

27116 PRESTANCIA WAY
SALINAS CA
93908-1556
US

V. Phone/Fax

Practice location:
  • Phone: 831-375-3577
  • Fax:
Mailing address:
  • Phone: 831-809-3166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95035473
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: