Provider Demographics
NPI:1063668804
Name:SPECTOR, ALEXANDRA CATHERINE (RN)
Entity Type:Individual
Prefix:MS
First Name:ALEXANDRA
Middle Name:CATHERINE
Last Name:SPECTOR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11848 MEAJEAN PL
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-4935
Mailing Address - Country:US
Mailing Address - Phone:619-203-8426
Mailing Address - Fax:
Practice Address - Street 1:2603 DENVER ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-3342
Practice Address - Country:US
Practice Address - Phone:619-203-8426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA464876163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse