Provider Demographics
NPI:1407981335
Name:BALKEY, ALEXIS ROSE
Entity type:Individual
Prefix:MRS
First Name:ALEXIS
Middle Name:ROSE
Last Name:BALKEY
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:ALEXIS
Other - Middle Name:ROSE
Other - Last Name:GARY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:66168 S AGUA DULCE DR
Mailing Address - Street 2:
Mailing Address - City:DESERT HOT SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92240-8111
Mailing Address - Country:US
Mailing Address - Phone:858-945-2539
Mailing Address - Fax:
Practice Address - Street 1:68100 RAMON RD
Practice Address - Street 2:B-10
Practice Address - City:CATHEDRAL CITY
Practice Address - State:CA
Practice Address - Zip Code:92234-3387
Practice Address - Country:US
Practice Address - Phone:760-321-0870
Practice Address - Fax:760-321-0916
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health