Look up the most recent NPI and PECOS records

Empowered Living Psychological Services, Inc.

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 Empowered Living Psychological Services, Inc. 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 33 days ago.

Profile Details

Provider ID
1831653021
Provider Type
Organization
Full Name
Empowered Living Psychological Services, Inc.

Subpart
No
Enumeration Date
1/22/2019
Last Updated
4/28/2021

Contact Information

Practice Location

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

(909) 652-0361

(909) 652-0241

Mailing Location

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

(909) 652-0361

(909) 652-0241

Authorized Official

Lockhart-Pettaway, Stefanie (Ceo/ Clinical Psychologist)

(909) 652-0361

Provider Taxonomies

Code	Description	License
Code 103T00000X Primary	Description Psychologist Behavioral Health & Social Service Providers	License Unlisted Issuer

Empowered Living Psychological Services, Inc.

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Authorized Official

Provider Taxonomies

Code

Description

License

Code

Description

License

Gunn Behavioral Care Of California, Pc

Hudspeth, Nina Christine

Lockhart-Pettaway, Stefanie

Health Service Alliance

Adhami, Sepideh

Inland Pacific Psychological Services

Lai, Pean

Keener, Rachel Joy

Wysocki, Steve Robert

Swan Psychological Services, Inc.