Roshanda Sharee Jackson Eichie

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

129242 Issued in CA

Practice address

14393 Park Avenue
Suite 200
Victorville, CA 92392

Phone

(442) 327-9135

NPI assigned

Feb 15, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Roshanda Jackson Eichie Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1676419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1295433662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30115",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924130115",
            "telephone_number": "909-659-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14393 PARK AVENUE",
            "address_2": "SUITE 200",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "92392",
            "telephone_number": "442-327-9135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EICHIE",
        "first_name": "ROSHANDA",
        "middle_name": "SHAREE JACKSON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-15",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "129242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSHANDA",
            "last_name": "EICHIE",
            "middle_name": "JACKSON",
            "credential": "AMFT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Educational & Behavioral Support Services, LLC
• Jenna Marie Edwards
• Roland Edwards
• Tiffany Edwards
• Eec
• Madelene Eilers-Fong
• Gloria Eitile
• Steve A. Eklund, M.D.
• Zoheir Rached El-Hajjaoui, M.D.
• May Eldanaf, PHARM D. RPH

• Clinical Psychologist in Victorville, CA
• Providers in Victorville, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.