Provider Demographics
NPI:1134358666
Name:BALICE, GUY FRANCIS (PHD)
Entity type:Individual
Prefix:DR
First Name:GUY
Middle Name:FRANCIS
Last Name:BALICE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28185 LITTLE LAKE CT
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92585-3180
Mailing Address - Country:US
Mailing Address - Phone:909-800-9562
Mailing Address - Fax:
Practice Address - Street 1:4107 MISSION INN AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-3125
Practice Address - Country:US
Practice Address - Phone:951-682-7143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY22638103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical