Brian Edward Raines, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY35461 Issued in CA

Practice address

12060 Industry Blvd # 1060
Jackson, CA 95642-9310

Phone

(209) 560-9443

NPI assigned

Jul 28, 2021

Last updated

Nov 30, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: brian.raines.p1@direct.macthealth.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• M a C T Health Board Incorporated

  • Federally Qualified Health Center (FQHC)
  • San Andreas, CA
  • NPI 1366519431

  TX

  Medicare reassignment NPD
• M a C T Health Board Incorporated

  dba MACT Medical Sonora

  • Federally Qualified Health Center (FQHC)
  • Sonora, CA
  • NPI 1467444364
  NPD
• M a C T Health Board, Incorporated

  dba MACT Health & Wellness, Sutter Creek

  • Federally Qualified Health Center (FQHC)
  • Sutter Creek, CA
  • NPI 1417741869
  NPD (past)

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

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732924800000",
    "number": "1598438285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12060 INDUSTRY BLVD # 1060",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956429310",
            "telephone_number": "209-560-9443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12060 INDUSTRY BLVD # 1060",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956429310",
            "telephone_number": "209-560-9443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAINES",
        "first_name": "BRIAN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-28",
        "last_updated": "2024-11-30",
        "certification_date": "2024-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY35461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marissa Lee Proverbs, PA-C
• Mary Catherine Pulskamp, MFT
• James Quirie
• Radiological Associates of Sacramento Medical Group Inc
• Shivani Raina
• McKenzie Sierra Rainwater
• Raleys
• Danuta Eliza Chojczak Ramaley, LCSW
• Ray Properties Kit Carson Inc. (Kit Carson Nursing and Rehabilitation Center)
• Allison Marie Regan

• Clinical Psychologist in Jackson, CA
• Providers in Jackson, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.