Active NPI
Mark F Fry, PHD, LP
- Clinical Psychologist
- Walnut Creek, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 19332
- Practice address
- 2970 Camino Diablo Ste 300
Walnut Creek, CA 94597-4001 - Phone
- (925) 282-1778
- Fax
- (415) 296-5299
- NPI assigned
- Jul 3, 2006
- 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 | 19332 | CA | Primary |
Addresses
Primary practice location
2970 Camino Diablo Ste 300
Walnut Creek, CA 94597-4001
Mailing address
2970 Camino Diablo Ste 300
Walnut Creek, CA 94597-4001
Phone (925) 282-1778
Other practice location 1
1226 Rossmoor Pkwy
Walnut Creek, CA 94595-2538
Phone (925) 975-5000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSY 193320 | Medicaid | CA |
Other names 1
- Mark Fry
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2970 Camino Diablo
Suite 300
Walnut Creek, CA 94597-4001
Phone (925) 282-1778
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19332 | CA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacific Coast Psychiatric Associates Inc | Clinical | Current | Accepting new patients |
Locations
1480 64th St
Ste 150
Emeryville, CA 94608
Phone (415) 296-5292
2970 Camino Diablo
Ste 300
Walnut Creek, CA 94597
Phone (925) 231-4225
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": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788998400000",
"number": "1699705053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2970 CAMINO DIABLO STE 300",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945974001",
"telephone_number": "925-282-1778",
"fax_number": "415-296-5299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2970 CAMINO DIABLO STE 300",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945974001",
"telephone_number": "925-282-1778",
"fax_number": "415-296-5299"
}
],
"practiceLocations": [
{
"address_1": "1226 ROSSMOOR PKWY",
"address_purpose": "LOCATION",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945952538",
"country_code": "US",
"telephone_number": "925-975-5000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FRY",
"first_name": "MARK",
"middle_name": "F",
"name_prefix": "Dr.",
"credential": "PHD, LP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-03",
"last_updated": "2026-09-10",
"certification_date": "2026-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "19332",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PSY 193320",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MARK",
"last_name": "FRY",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Walnut Creek, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.