Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | PSY19575 | CA |
Y | 103G00000X | Clinical Psychologist | PSY19575 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY19575 | CA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | PSY19575 | CA |
NPI | 1003075235 |
---|---|
Provider Name | Dr. Desiree Delagarza Purcell |
First Address | Laguna Beach, CA 92651-3681 |
Second Address | Irvine, CA 92618-7306 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2008 |
Last Update Date | 26/01/2021 |