Individual provider Active NPI

Raymond Devon Brockett

  • Day Training/Habilitation Specialist
  • Brentwood, CA
National Provider Identifier
1053288498
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Day Training/Habilitation SpecialistTaxonomy code 373H00000X
Practice address
355 Orchard Dr
Brentwood, CA 94513-1551
Phone
(510) 904-7175
Fax
(510) 904-7175
NPI assigned
Oct 21, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Day Training/Habilitation Specialist 373H00000X CA Primary

Addresses

Primary practice location

355 Orchard Dr
Brentwood, CA 94513-1551

Mailing address

355 Orchard Dr
Brentwood, CA 94513-1551
Phone (510) 904-7175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1761004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1053288498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 ORCHARD DR",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945131551",
            "telephone_number": "510-904-7175",
            "fax_number": "510-904-7175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 ORCHARD DR",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945131551",
            "telephone_number": "510-904-7175",
            "fax_number": "510-904-7175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKETT",
        "first_name": "RAYMOND",
        "middle_name": "DEVON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-10-21",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.