NPIMap

Organization Active NPI

Socal Rehab Associates Inc

Doing business as Brockton Physical Therapy

  • Physical Therapist
  • Riverside, CA
National Provider Identifier
1780662718
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4384172S Issued in CA
Legal business name
SOCAL REHAB ASSOCIATES INC
Doing business as
Brockton Physical Therapy
Practice address
3908 10TH St
Riverside, CA 92501-3522
Phone
(951) 274-7744
Fax
(951) 274-7754
NPI assigned
Jan 9, 2006
Last updated
Sep 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Authorized official

Name
Trevyn Loy Despain, PTNPI 1063490092
Title
Owner Physical Therapist
Phone
(951) 274-7744

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4384172S CA Primary

Addresses

Primary practice location

3908 10TH St
Riverside, CA 92501-3522

Mailing address

3908 10TH St
Riverside, CA 92501-3522
Phone (951) 274-7744

Other practice location 1

4343 Market St Ste B
Riverside, CA 92501-3567
Phone (951) 274-7744

Other names 1

  • Brockton Physical Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040311000781 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3274422951 Receives reassigned benefits from 6 practitioners
Practice locations: Riverside, CA

National Provider Directory

National Provider Directory

Locations

701 Highland Springs Ave
Ste 6
Beaumont, CA 92223
Phone (909) 769-0300

3908 10th St
Riverside, CA 92501
Phone (909) 274-7744

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758585600000",
    "number": "1780662718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3908 10TH ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013522",
            "telephone_number": "951-274-7744",
            "fax_number": "951-274-7754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3908 10TH ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013522",
            "telephone_number": "951-274-7744",
            "fax_number": "951-274-7754"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4343 Market St Ste B",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925013567",
            "country_code": "US",
            "telephone_number": "951-274-7744",
            "fax_number": "951-274-7754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOCAL REHAB ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-09",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A",
        "authorized_official_last_name": "DESPAIN",
        "authorized_official_first_name": "TREVYN",
        "authorized_official_middle_name": "LOY",
        "authorized_official_title_or_position": "OWNER PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "951-274-7744",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "4384172S",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brockton Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.