Active NPI
Mark Evert Barnes, PH.D.
- Clinical Psychologist
- Fresno, CA
National Provider Identifier
1124172002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY14397
- Practice address
- 5080 N Fruit Ave Ste 103
Fresno, CA 93711-3062 - Phone
- (559) 978-3339
- Fax
- (559) 412-7207
- NPI assigned
- Jan 22, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY14397 | CA | Primary |
Addresses
Primary practice location
5080 N Fruit Ave Ste 103
Fresno, CA 93711-3062
Mailing address
5080 North Fruit Suite 103
Fresno, CA 93711-3204
Phone (559) 978-3339
Other practice location 1
1680 W Shaw Ave Ste 100
Fresno, CA 93711-3504
Phone (559) 978-6572
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 822126301 | Other | CA | TAX ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY14397 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Victor Community Support Services, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Fresno, CA
- NPI 1669346706
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779062400000",
"number": "1124172002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5080 NORTH FRUIT SUITE 103",
"city": "FRESNO",
"state": "CA",
"postal_code": "937113204",
"telephone_number": "559-978-3339",
"fax_number": "559-412-7207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5080 N FRUIT AVE STE 103",
"city": "FRESNO",
"state": "CA",
"postal_code": "937113062",
"telephone_number": "559-978-3339",
"fax_number": "559-412-7207"
}
],
"practiceLocations": [
{
"address_1": "1680 W Shaw Ave Ste 100",
"address_purpose": "LOCATION",
"city": "Fresno",
"state": "CA",
"postal_code": "937113504",
"country_code": "US",
"telephone_number": "559-978-6572",
"fax_number": "559-558-4899",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BARNES",
"first_name": "MARK",
"middle_name": "EVERT",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-22",
"last_updated": "2026-05-18",
"certification_date": "2026-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY14397",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "822126301",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 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.