Provider Demographics
NPI:1861601783
Name:RODGERS, LUANNA LORRAINE (MFT)
Entity type:Individual
Prefix:MISS
First Name:LUANNA
Middle Name:LORRAINE
Last Name:RODGERS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3850 17TH ST
Mailing Address - Street 2:CASTRO MISSION HLTH CTR
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-2031
Mailing Address - Country:US
Mailing Address - Phone:415-487-7527
Mailing Address - Fax:
Practice Address - Street 1:3850 17TH ST
Practice Address - Street 2:CASTRO MISSION HEALTH CENTER
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-2031
Practice Address - Country:US
Practice Address - Phone:415-641-8890
Practice Address - Fax:415-558-8221
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC24105106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist