Healthcare Provider Details
I. General information
NPI: 1558506865
Provider Name (Legal Business Name): SEAN ERIC ROUGEAU N.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/16/2008
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3208 ROSEMEAD BLVD SUITE 200
EL MONTE CA
91731
US
IV. Provider business mailing address
3208 ROSEMEAD BLVD SUITE 200
EL MONTE CA
91731-2830
US
V. Phone/Fax
- Phone: 626-227-7014
- Fax:
- Phone: 626-227-7014
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | 95003703 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WA2000X |
| Taxonomy | Administrator Registered Nurse |
| License Number | 523801 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 95003703 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: