Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Destinee Nicole Gannuscio

Individual provider Mental Health Counselor · NPI 1265957518

Destinee Nicole Gannuscio is a Marriage and Family Therapist in LA Habra, California. Qualified in 2019, 7 years ago. Practices with Sud Specialty Group - Ca, a 499-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
7
Licensed in
CA
In the registry since
2017
Specialties on file
2
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Practice location Address checks out

101 Roscoe St
LA Habra, CA 90631-4240
Phone: (951) 254-2025
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Marriage & Family Therapist (primary) Taxonomy 106H00000X · Licence 133797 (CA)
Mental Health Counselor Taxonomy 101YM0800X

Record details

NPI number1265957518
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedAugust 8, 2017
Last updated in NPPESAugust 15, 2022
Certification dateAugust 15, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMARRIAGE AND FAMILY THERAPIST
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Sud Specialty Group - Ca — 499 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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