Healthcare Provider Details

I. General information

NPI: 1720934698
Provider Name (Legal Business Name): THE VEIN LUXE ACADEMY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2026
Last Update Date: 08/02/2026
Certification Date: 08/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30375 SUMMERSIDE ST
MURRIETA CA
92563-6807
US

IV. Provider business mailing address

30375 SUMMERSIDE ST
MURRIETA CA
92563-6807
US

V. Phone/Fax

Practice location:
  • Phone: 951-440-7001
  • Fax:
Mailing address:
  • Phone: 951-440-7001
  • Fax: 951-440-7001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MRS. JANICE LYNN CORBO
Title or Position: LVN/OWNER
Credential: LVN
Phone: 951-440-7001