Active NPI
Blush Beauty Aesthetics
- Family Medicine Physician
- Canyon Lake, CA
National Provider Identifier
1740163450
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- BLUSH BEAUTY AESTHETICS
- Doing business as
- Blush Beauty Aesthetics
- Practice address
- 24370 Canyon Lake Dr N Ste 8
Canyon Lake, CA 92587-8041 - Phone
- (951) 516-1102
- NPI assigned
- Jul 29, 2025
- Last updated
- Jul 29, 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
- Donnae Trabbie, RN
- Title
- President
- Phone
- (951) 516-1102
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | NU | Primary |
Addresses
Primary practice location
24370 Canyon Lake Dr N Ste 8
Canyon Lake, CA 92587-8041
Mailing address
24370 Canyon Lake Dr N Ste 8
Canyon Lake, CA 92587-8041
Phone (951) 516-1102
Other names 1
- Blush Beauty Aesthetics
National Provider Directory
National Provider DirectoryLocations
24370 Canyon Lake Dr N
Ste 8
Canyon Lake, CA 92587
Phone (951) 516-1102
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1753747200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1753747200000",
"number": "1740163450",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24370 CANYON LAKE DR N STE 8",
"city": "CANYON LAKE",
"state": "CA",
"postal_code": "925878041",
"telephone_number": "951-516-1102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24370 CANYON LAKE DR N STE 8",
"city": "CANYON LAKE",
"state": "CA",
"postal_code": "925878041",
"telephone_number": "951-516-1102"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BLUSH BEAUTY AESTHETICS",
"organizational_subpart": "NO",
"enumeration_date": "2025-07-29",
"last_updated": "2025-07-29",
"certification_date": "2025-07-29",
"status": "A",
"authorized_official_last_name": "TRABBIE",
"authorized_official_first_name": "DONNAE",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "951-516-1102",
"authorized_official_credential": "RN"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Blush Beauty Aesthetics",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Canyon Lake, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.