Provider Demographics
NPI:1841938388
Name:LUTHER, ROBERT SHAWN (RADT-I)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:SHAWN
Last Name:LUTHER
Suffix:
Gender:M
Credentials:RADT-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4667 18TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-1833
Mailing Address - Country:US
Mailing Address - Phone:415-283-8300
Mailing Address - Fax:
Practice Address - Street 1:1035 MARKET ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-1600
Practice Address - Country:US
Practice Address - Phone:415-487-8067
Practice Address - Fax:415-558-9657
Is Sole Proprietor?:No
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASUDRC13210101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)