Dr. Gary G. Balestin, PhD, ABPN, LMFT
Psychologist, Intellectual & Developmental Disabilities in South San Francisco, CA. Individual provider (NPI-1).
NPI number1902878366
StatusActive
Last updated in NPPESSep 11, 2025
Details
- NPI
- 1902878366
- Entity type
- Individual (NPI-1)
- Name
- Dr. Gary G. Balestin
- Credential
- PhD, ABPN, LMFT
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 1, 2006
- Last updated
- Sep 11, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TM1800X | Psychologist, Intellectual & Developmental Disabilities | PSY5030 | CA | Yes |
| 103TC2200X | Psychologist, Clinical Child & Adolescent | PSY5030 | CA | |
| 103TR0400X | Psychologist, Rehabilitation | PSY5030 | CA | |
| 103TF0200X | Psychologist, Forensic | PSY5030 | CA | |
| 103G00000X | Clinical Neuropsychologist | PSY5030 | CA | |
| 103TC0700X | Psychologist, Clinical | PSY5030 | CA | |
| 106H00000X | Marriage & Family Therapist | LMFT6806 | CA |
Practice location
1475 Huntington AveSuite 201
South San Francisco, CA 94080-5990
Phone 650-588-3808 · Fax 650-873-5857
Mailing address
1475 Huntington AveSuite 201
South San Francisco, CA 94080-5990
Phone 650-588-3808 · Fax 650-873-5857
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