Individual
MR. SHAUN MARVIN LUTHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
776 W LONGVIEW AVE, STOCKTON, CA 95207-4713
(951) 215-8465
Mailing address
776 W LONGVIEW AVE, STOCKTON, CA 95207-4713
(951) 215-8465
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95034866
CA
390200000X
Student in an Organized Health Care Education/Training Program
814023
CA
Other
Enumeration date
12/05/2023
Last updated
05/07/2025
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