Active NPI
Devante Andraes Raynor, MSW, BSW
- Clinical Social Worker
- Elk Grove, CA
National Provider Identifier
1417608035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 133445
- Practice address
- 9412 Big Horn Blvd Ste 6
Elk Grove, CA 95758-1101 - Phone
- (503) 747-0404
- NPI assigned
- Jan 14, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | T-21-1344 | OR | |
| Rehabilitation Practitioner | 225400000X | CA | ||
| Clinical Social Worker | 1041C0700X | 133445 | CA | Primary |
Addresses
Primary practice location
9412 Big Horn Blvd Ste 6
Elk Grove, CA 95758-1101
Mailing address
9412 Big Horn Blvd Ste 6
Elk Grove, CA 95758-1101
Phone (916) 879-2178
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T-21-1344 | OR | MD | Addiction (Substance Use Disorder) Counselor |
| 133445 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756425600000",
"number": "1417608035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9412 BIG HORN BLVD STE 6",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "957581101",
"telephone_number": "916-879-2178"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9412 BIG HORN BLVD STE 6",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "957581101",
"telephone_number": "503-747-0404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAYNOR",
"first_name": "DEVANTE",
"middle_name": "ANDRAES",
"credential": "MSW, BSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-01-14",
"last_updated": "2025-08-29",
"certification_date": "2025-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OR",
"license": "T-21-1344",
"primary": false
},
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "133445",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elk Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.