MEDICARE: DR. GUY FRANCIS BALICE PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PSY22638	CA

General Provider Information

NPI Number	:	1134358666
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GUY FRANCIS BALICE PH.D.

Provider Business Mailing Address
First Line	:	28185 LITTLE LAKE CT
Second Line	:
City	:	SUN CITY
State	:	CA
Zip	:	92585-3180
Country	:	US
Telephone Number	:	909-800-9562
Fax Number	:

Provider Business Practice Location Address
First Line	:	4107 MISSION INN AVE
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92501-3125
Country	:	US
Telephone Number	:	951-682-7143
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2009
Last Update Date	:	07/06/2009

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