Active NPI
Supernatural Beauty & Aesthetics Medical Group, PC
- Family Medicine Physician
- Ben Lomond, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- 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
- Last updated
- Aug 11, 2025
- Organization subpart
- No
NPPES NPI Registry
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
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | |||
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
10090 Highway 9 Ste 8
Ben Lomond, CA 95005-9251
Mailing address
10090 Highway 9 Ste 8
Ben Lomond, CA 95005-9251
National Provider Directory
National Provider DirectoryLocations
10090 Highway 9
Ste 8
Ben Lomond, CA 95005
Phone (661) 889-5728
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- General Practice Registered Nurse
- Boulder Creek, CA
- NPI 1679368328
NPI Registry JSON
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": []
}
Other providers in Ben Lomond, CA
Sources for this page
- 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.