Individual provider Active NPI

Alexandra Mouannes

  • Pediatric Occupational Therapist
  • San Diego, CA
National Provider Identifier
1699617647
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
25656 Issued in CA
Practice address
3078 Broadway Unit 203
San Diego, CA 92102-2348
Phone
(763) 226-1407
NPI assigned
Apr 8, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 25656 CA Primary

Addresses

Primary practice location

3078 Broadway Unit 203
San Diego, CA 92102-2348

Mailing address

3078 Broadway Unit 203
San Diego, CA 92102-2348

Other names 1

  • Lexy Mouannes Other name

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
25656CAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Little Trailblazers OT Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1775606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1699617647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3078 BROADWAY UNIT 203",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921022348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3078 BROADWAY UNIT 203",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921022348",
            "telephone_number": "763-226-1407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUANNES",
        "first_name": "ALEXANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-08",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "25656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEXY",
            "last_name": "MOUANNES",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2026; 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.