Gary G. Balestin, PHD, ABPN, LMFT

Primary specialty

Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X

License

PSY5030 Issued in CA

Practice address

1475 Huntington Ave
Suite 201
South San Francisco, CA 94080-5990

Phone

(650) 588-3808

Fax

(650) 873-5857

NPI assigned

Feb 1, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 7

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1902878366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 HUNTINGTON AVE",
            "address_2": "SUITE 201",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940805990",
            "telephone_number": "650-588-3808",
            "fax_number": "650-873-5857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 HUNTINGTON AVE",
            "address_2": "SUITE 201",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940805990",
            "telephone_number": "650-588-3808",
            "fax_number": "650-873-5857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALESTIN",
        "first_name": "GARY",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "PHD, ABPN, LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY5030",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY5030",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT6806",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "PSY5030",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "CA",
            "license": "PSY5030",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "CA",
            "license": "PSY5030",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "CA",
            "license": "PSY5030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James H. Bainton, MD
• Ada Patricia Bajada, NP
• Alexis Bright Baker, MFT INTERN #80201
• Jnyssienne Baker, DPT
• Jerry Bales, PHARM.D.
• Vicken Harout Balian
• Ali Reza Bamdad, D.C.
• Kiiko Y Baptista
• Leonidez Baquiran
• Sofia Diana Barahona Bonilla

• All providers in South San Francisco, CA
• Intellectual & Developmental Disabilities Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.