Shanice Rose Edwards

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

141445 Issued in CA

Practice address

325 W Hospitality LN Ste 112
San Bernardino, CA 92408-3211

Phone

(909) 763-5803

NPI assigned

May 10, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Victor Community Support Services, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • San Bernardino, CA
  • NPI 1982756714
  NPD

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

{
    "created_epoch": "1557446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1821654252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 W HOSPITALITY LN STE 112",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083211",
            "telephone_number": "909-763-5803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 W HOSPITALITY LN STE 112",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083211",
            "telephone_number": "909-763-5803"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1908 Business Center Dr",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924083436",
            "country_code": "US",
            "telephone_number": "909-890-5930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "SHANICE",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-10",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "141445",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "141445",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charneka Edwards
• Devin Wayne Edwards
• Lanita Marie Edwards
• Lincoln Paul Edwards, DDS
• Miya Edwards, MS
• Edwin Romel S. de Leon, M.D., Inc.
• Catherine Efevberha, LMFT
• Edima Bassey Effiong, LVN
• Eric Alemnji Efuetngu, FNP-C
• Mavis Efuetngu, PMHNP

• Clinical Social Worker in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; 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.