Active NPI
Desiree Delagarza Purcell, DOCTORATE
- Clinical Psychologist
- Laguna Beach, CA
National Provider Identifier
1003075235
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY19575
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210126000421 | CA | Practitioner - Clinical Psychologist | 6709290166 | Practice locations: Laguna Beach, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY19575 | CA | MD | Cognitive & Behavioral Psychologist |
Practice roles
| Organization | Specialty | Status | New 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
- 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.
-
- Clinical Neuropsychologist
- Dallas, TX
- NPI 1093583593
-
- Family Medicine Physician
- Lewisville, TX
- NPI 1245403567
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.