Healthcare Provider Details

I. General information

NPI: 1033064951
Provider Name (Legal Business Name): ELITE ACADEMIC ACADEMY - LUCERNE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

43414 BUSINESS PARK DR
TEMECULA CA
92590-5526
US

IV. Provider business mailing address

43414 BUSINESS PARK DR
TEMECULA CA
92590-5526
US

V. Phone/Fax

Practice location:
  • Phone: 951-583-1520
  • Fax:
Mailing address:
  • Phone: 951-583-1520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: LAURA K SPENCER
Title or Position: CHIEF ACADEMIC OFFICER
Credential:
Phone: 951-583-1520