Provider Demographics
NPI:1366727380
Name:MURDOCK, PAUL D (PSYD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:D
Last Name:MURDOCK
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9700 EL CAMINO REAL
Mailing Address - Street 2:303
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422-5569
Mailing Address - Country:US
Mailing Address - Phone:805-460-6383
Mailing Address - Fax:
Practice Address - Street 1:9700 EL CAMINO REAL
Practice Address - Street 2:303
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-5569
Practice Address - Country:US
Practice Address - Phone:805-460-6383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-21
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24614103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical