Provider Demographics
NPI:1093599854
Name:LONGHIN, LEAH (DC)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:LONGHIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:TEMPLETON
Mailing Address - State:CA
Mailing Address - Zip Code:93465-5100
Mailing Address - Country:US
Mailing Address - Phone:805-434-2077
Mailing Address - Fax:805-434-2079
Practice Address - Street 1:61 E 5TH ST
Practice Address - Street 2:
Practice Address - City:TEMPLETON
Practice Address - State:CA
Practice Address - Zip Code:93465-5100
Practice Address - Country:US
Practice Address - Phone:805-434-2077
Practice Address - Fax:805-434-2079
Is Sole Proprietor?:No
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36742111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor