Supernatural Beauty & Aesthetics Medical Group, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SUPERNATURAL BEAUTY & AESTHETICS MEDICAL GROUP, PC

Practice address

10090 Highway 9 Ste 8
Ben Lomond, CA 95005-9251

Phone

(661) 889-5728

NPI assigned

Aug 11, 2025

Organization subpart

No

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

Authorized official

Name

Brandi Phillips, RN

Title

Secretary

Phone

(661) 889-5728

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1754870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754870400000",
    "number": "1699650267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10090 HIGHWAY 9 STE 8",
            "city": "BEN LOMOND",
            "state": "CA",
            "postal_code": "950059251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10090 HIGHWAY 9 STE 8",
            "city": "BEN LOMOND",
            "state": "CA",
            "postal_code": "950059251",
            "telephone_number": "661-889-5728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERNATURAL BEAUTY & AESTHETICS MEDICAL GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-11",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "BRANDI",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "661-889-5728",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marc D. Shaw, OD
• Sol Brook Silverman
• David James Simpson
• Jamie Marie Smoak, DC
• Ruby Esther Souza-Young
• Brett R Traynor
• Shannon Vasquez Gonzalez
• Isabella Vasquez
• Adrian Grant Vega
• Courtney Walter

• Family Medicine Physician in Ben Lomond, CA
• Providers in Ben Lomond, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; 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.