{"npi":"1699705053","type":"NPI-1","status":"active","name":{"display":"Dr. Mark Fry PHD, Lp","other":[{"code":"1","type":"Formerly known as","value":"FRY, MARK"}],"first":"MARK","last":"FRY","middle":"F","credential":"PHD, LP"},"specialty":{"primary_taxonomy":"103T00000X","primary_taxonomy_description":"Psychologist","slug":"psychologist","schema_org_specialty":null,"all":[{"code":"103T00000X","description":"Psychologist","primary":true,"state":"CA","license":"19332"}]},"addresses":[{"purpose":"LOCATION","street_1":"2970 CAMINO DIABLO STE 300","city":"WALNUT CREEK","state":"CA","postal_code":"945974001","country_code":"US","phone":"9252821778","fax":"4152965299"},{"purpose":"MAILING","street_1":"2970 CAMINO DIABLO STE 300","city":"WALNUT CREEK","state":"CA","postal_code":"945974001","country_code":"US","phone":"9252821778","fax":"4152965299"}],"license":{"state":"CA","number":"19332"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"PSY 193320","state":"CA","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20040131000302","type_code":"14-68","type_desc":"PRACTITIONER - CLINICAL PSYCHOLOGIST","state":"CA","pac_id":"1658274097"}]},"enumeration_date":"2006-07-03","last_updated":"2025-07-14","_meta":{"source":"NPPES","snapshot_date":"2025-07-14","doc_url":"https://findmynpi.com/api"}}