Individual provider Active NPI

Mark Evert Barnes, PH.D.

  • Clinical Psychologist
  • Fresno, CA
National Provider Identifier
1124172002
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY14397 Issued in CA
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

Updated by the provider on May 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
822126301OtherCATAX 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

LicenseStateTypeSpecialty
PSY14397CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Victor Community Support Services, Inc. PastSince Oct 1, 2025 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.

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.

Verify at the official NPI Registry.