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General NPI Number Information
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NPI Number | 1740163450
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Entity Type | Organization
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Legal Business Name | BLUSH BEAUTY AESTHETICS
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Dates
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Enumeration Date | 07/29/2025
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 24370 CANYON LAKE DR N STE 8
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City | CANYON LAKE
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State | CA
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Zip | 92587-8041
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Country | US
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Telephone | 951-516-1102
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Fax |
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Provider Business Mailing Address
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Address Line | 24370 CANYON LAKE DR N STE 8
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City | CANYON LAKE
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State | CA
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Zip | 92587-8041
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Country | US
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Telephone | 951-516-1102
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DONNAE TRABBIE
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Credential | RN
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Telephone | 951-516-1102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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