Provider Demographics
NPI:1326064049
Name:THRASHER, ROBERT CHARLES (LMFT)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:CHARLES
Last Name:THRASHER
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 PACIFIC COAST HWY.
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SEAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90740
Mailing Address - Country:US
Mailing Address - Phone:562-477-1624
Mailing Address - Fax:562-597-2623
Practice Address - Street 1:610 PACIFIC COAST HWY.
Practice Address - Street 2:SUITE 201
Practice Address - City:SEAL BEACH
Practice Address - State:CA
Practice Address - Zip Code:90740
Practice Address - Country:US
Practice Address - Phone:562-477-1624
Practice Address - Fax:562-477-1624
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT14990106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMFT14990OtherMFT