Healthcare Provider Details

I. General information

NPI: 1346048246
Provider Name (Legal Business Name): SEAN ROMEO LAURANT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2025
Last Update Date: 10/03/2026
Certification Date: 10/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 PRISON RD
REPRESA CA
95671-3000
US

IV. Provider business mailing address

511 HACIENDA LN
SUISUN CITY CA
94585-3076
US

V. Phone/Fax

Practice location:
  • Phone: 916-985-8610
  • Fax:
Mailing address:
  • Phone: 707-803-0343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW139184
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: