Organization
CENTRA PEDIATRIC THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WAYNE BRIAN CENTRA OT (OWNER/OCCUPATIONAL THERAPIST)
(714) 731-4668
Entity
Organization
Contact information
Practice address
3002 DOW AVE STE 114, TUSTIN, CA 92780-7247
(714) 731-4668
(714) 464-4668
Mailing address
3002 DOW AVE #114, TUSTIN, CA 92780-7236
(714) 731-4668
(714) 464-4668
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
—
—
225XF0002X
Feeding, Eating & Swallowing Occupational Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
01/20/2012
Last updated
10/22/2025
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