Individual ProviderSteve Robert WysockiPsychologistBehavioral Health & Social Service ProvidersPractice Address9089 Baseline Rd Ste 200, Rancho Cucamonga, CA 91730-1295(909) 980-3567PECOS EnrollmentThis provider is enrolled in PECOS as STEPHEN WYSOCKI.Based on the most recent information from CMS, provider Steve Robert Wysocki is legally eligible to order and refer claims for DME services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 34 days ago.Profile DetailsProvider ID1245319276Provider TypeIndividualFull NameWysocki, Steve RobertTitleDr.CredentialPH.D.GenderMaleSole ProprietorYesEnumeration Date11/2/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address9089 Baseline Rd Ste 200, Rancho Cucamonga, CA 91730-1295Phone(909) 980-3567Fax(909) 989-3932Mailing LocationMailing Address9089 Baseline Rd Ste 200, Rancho Cucamonga, CA 91730-1295Phone(909) 980-3567Fax(909) 989-3932Provider TaxonomiesCodeDescriptionLicenseCode103T00000XPrimaryDescriptionPsychologistBehavioral Health & Social Service ProvidersLicensePSY6143California