Provider Demographics
NPI:1538312400
Name:ARCHBALD, THOMAS FROTHINGHAM (MA)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:FROTHINGHAM
Last Name:ARCHBALD
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 S DUNNING ST
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-3306
Mailing Address - Country:US
Mailing Address - Phone:805-651-8738
Mailing Address - Fax:
Practice Address - Street 1:212 S DUNNING ST
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-3306
Practice Address - Country:US
Practice Address - Phone:805-651-8738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32399101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist