Provider Demographics
NPI:1033945704
Name:PORRAS, DESIREE (AMFT)
Entity type:Individual
Prefix:
First Name:DESIREE
Middle Name:
Last Name:PORRAS
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:DESIREE
Other - Middle Name:
Other - Last Name:LOREDO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AMFT
Mailing Address - Street 1:83052 CARMEL MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92203-3512
Mailing Address - Country:US
Mailing Address - Phone:760-610-4361
Mailing Address - Fax:
Practice Address - Street 1:35325 DATE PALM DR STE 122
Practice Address - Street 2:
Practice Address - City:CATHEDRAL CITY
Practice Address - State:CA
Practice Address - Zip Code:92234-7030
Practice Address - Country:US
Practice Address - Phone:760-610-4361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA144606106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist