Individual provider Active NPI

Desiree Delagarza Purcell, DOCTORATE

  • Clinical Psychologist
  • Laguna Beach, CA
National Provider Identifier
1003075235
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY19575 Issued in CA
Practice address
1968 S Coast Hwy # 996
Laguna Beach, CA 92651-3681
Phone
(949) 370-9442
Fax
(361) 353-4408
NPI assigned
Jun 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X PSY19575 CA
Clinical Child & Adolescent Psychologist 103TC2200X PSY19575 CA
Clinical Psychologist 103TC0700X PSY19575 CA Primary

Addresses

Primary practice location

1968 S Coast Hwy # 996
Laguna Beach, CA 92651-3681

Mailing address

1968 S Coast Hwy
# 996
Laguna Beach, CA 92651-3681
Phone (949) 370-9442

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210126000421 CA Practitioner - Clinical Psychologist 6709290166 Practice locations: Laguna Beach, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY19575CAMDCognitive & Behavioral Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Neuropsychology Me PLLC Clinical Current Accepting new patients
Teladoc Health Medical Group, P.a. Current Accepting new patients

Locations

1968 S Coast Hwy
Laguna Beach, CA 92651
Phone (619) 547-1856

Interoperability endpoints

  • Direct secure messaging: desireedelagarza@tdh.allscriptsdirect.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1003075235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1968 S COAST HWY",
            "address_2": "# 996",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926513681",
            "telephone_number": "949-370-9442",
            "fax_number": "949-248-2230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1968 S COAST HWY # 996",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926513681",
            "telephone_number": "949-370-9442",
            "fax_number": "361-353-4408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURCELL",
        "first_name": "DESIREE",
        "middle_name": "DELAGARZA",
        "name_prefix": "Dr.",
        "credential": "DOCTORATE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-03",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CA",
            "license": "PSY19575",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "PSY19575",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY19575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Beach, CA

Sources for this page

Verify at the official NPI Registry.