Provider Demographics
NPI:1639592553
Name:RAYNOR, JANELLE K (LPCC)
Entity type:Individual
Prefix:
First Name:JANELLE
Middle Name:K
Last Name:RAYNOR
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2167 SHAW AVE STE 115
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-8935
Mailing Address - Country:US
Mailing Address - Phone:510-920-9631
Mailing Address - Fax:
Practice Address - Street 1:11178 HIGHWAY 41 STE 1101D
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93636-9051
Practice Address - Country:US
Practice Address - Phone:510-920-9631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-29
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPCC7531101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional