Individual provider Active NPI

Matthew Donald Misuraca, MA, LMFT

  • Marriage & Family Therapist
  • Palm Desert, CA
National Provider Identifier
1417370420
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 53014 Issued in CA
Practice address
74133 El Paseo
Suite 11
Palm Desert, CA 92260-4119
Phone
(760) 708-8253
Fax
(760) 779-5600
NPI assigned
Jan 27, 2014
Last updated
Jul 21, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC 53014 CA Primary

Addresses

Primary practice location

74133 El Paseo
Suite 11
Palm Desert, CA 92260-4119

Mailing address

74133 El Paseo
Suite 11
Palm Desert, CA 92260-4119
Phone (760) 708-8253

Other practice location 1

7885 Annandale Ave
Desert Hot Springs, CA 92240-1419
Phone (760) 329-2924

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Nov 13, 2025 through Nov 13, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MFC 53014CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Ranch Recovery Centers Inc Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1390780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1417370420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74133 EL PASEO",
            "address_2": "SUITE 11",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922604119",
            "telephone_number": "760-708-8253",
            "fax_number": "760-779-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74133 EL PASEO",
            "address_2": "SUITE 11",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922604119",
            "telephone_number": "760-708-8253",
            "fax_number": "760-779-5600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7885 Annandale Ave",
            "address_purpose": "LOCATION",
            "city": "Desert Hot Springs",
            "state": "CA",
            "postal_code": "922401419",
            "country_code": "US",
            "telephone_number": "760-329-2924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MISURACA",
        "first_name": "MATTHEW",
        "middle_name": "DONALD",
        "credential": "MA, LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-27",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 53014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Desert, CA

Sources for this page

Verify at the official NPI Registry.