Stefanie Lockhart-Pettaway | Rancho Cucamonga, CA • PECOS Search

Stefanie Lockhart-Pettaway

Psychologist

Behavioral Health & Social Service Providers

9113 Foothill Blvd Ste 130, Rancho Cucamonga, CA 91730-6565

PECOS Enrollment

Based on the most recent information from CMS, provider Stefanie Lockhart-Pettaway does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 34 days ago.

Profile Details

Provider ID
1497934871
Provider Type
Individual
Full Name
Lockhart-Pettaway, Stefanie
Title
Dr.
Credential
PSY.D, MSW

Gender
Female
Sole Proprietor
Yes
Enumeration Date
11/1/2007
Last Updated
1/14/2019

Contact Information

Practice Location

9113 Foothill Blvd Ste 130, Rancho Cucamonga, CA 91730-6565

(909) 652-0241

Mailing Location

9113 Foothill Blvd Ste 130, Rancho Cucamonga, CA 91730-6565

(909) 652-0241

Provider Taxonomies

Code	Description	License
Code 103T00000X Primary	Description Psychologist Behavioral Health & Social Service Providers	License PSY 24837 California