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General NPI Number Information
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NPI Number | 1396587705
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Entity Type | Organization
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Legal Business Name | LUXX FACIAL SPA LLC
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Dates
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Enumeration Date | 06/07/2024
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Last Update Date | 06/07/2024
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Provider Practice Location Address
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Address Line | 43020 BLACK DEER LOOP STE 204
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City | TEMECULA
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State | CA
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Zip | 92590-3406
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Country | US
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Telephone | 951-528-0601
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Fax |
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Provider Business Mailing Address
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Address Line | 43020 BLACK DEER LOOP STE 204
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City | TEMECULA
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State | CA
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Zip | 92590-3406
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Country | US
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Telephone | 951-528-0601
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | VERONICA WILLIAMS
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Credential | FNP
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Telephone | 951-528-0601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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