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 3 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