Provider Demographics
NPI:1003075235
Name:PURCELL, DESIREE DELAGARZA (DOCTORATE)
Entity Type:Individual
Prefix:DR
First Name:DESIREE
Middle Name:DELAGARZA
Last Name:PURCELL
Suffix:
Gender:F
Credentials:DOCTORATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1968 S COAST HWY
Mailing Address - Street 2:# 996
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651-3681
Mailing Address - Country:US
Mailing Address - Phone:949-370-9442
Mailing Address - Fax:949-248-2230
Practice Address - Street 1:1968 S COAST HWY # 996
Practice Address - Street 2:
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651-3681
Practice Address - Country:US
Practice Address - Phone:949-370-9442
Practice Address - Fax:361-353-4408
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY19575103TB0200X, 103TC2200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent