Individual
IAN LONGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5007 KENNETH AVE, FAIR OAKS, CA 95628-5329
(530) 304-4638
Mailing address
3840 ROSIN CT STE 240, SACRAMENTO, CA 95834-1645
(530) 487-2656
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
07/27/2022
Last updated
04/24/2025
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