Provider Demographics
NPI:1376649194
Name:ARCHIBALD, FAITH (PT)
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:
Last Name:ARCHIBALD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:FAITH
Other - Middle Name:
Other - Last Name:SCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16573 VENTURA BLVD
Mailing Address - Street 2:SUITE #5
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2008
Mailing Address - Country:US
Mailing Address - Phone:818-990-0868
Mailing Address - Fax:818-990-2868
Practice Address - Street 1:16573 VENTURA BLVD
Practice Address - Street 2:SUITE #5
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2008
Practice Address - Country:US
Practice Address - Phone:818-990-0868
Practice Address - Fax:818-990-2868
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32948225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT32948AMedicare PIN