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General NPI Number Information
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NPI Number | 1134358666
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Entity Type | Individual
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Provider Name | GUY FRANCIS BALICE PH.D.
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Gender | Male
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Dates
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Enumeration Date | 07/06/2009
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Last Update Date | 07/06/2009
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Provider Practice Location Address
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Address Line | 4107 MISSION INN AVE
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City | RIVERSIDE
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State | CA
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Zip | 92501-3125
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Country | US
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Telephone | 951-682-7143
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Fax |
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Provider Business Mailing Address
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Address Line | 28185 LITTLE LAKE CT
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City | SUN CITY
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State | CA
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Zip | 92585-3180
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Country | US
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Telephone | 909-800-9562
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY22638
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License Number State | CA
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