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JACOB MILTON MURDOCK IV
NPI 1124555461
Student in an Organized Health Care Education/Training Program in Lakeside, CA

Active since May 17, 2017
12064 WOODSIDE AVE SUITE 105, SAN DIEGO CENTER FOR NEUROFEEDBACK, LAKESIDE, CA 92040(619) 436-4263 Get Directions Write a Review

NPPES record last updated: May 17, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jacob Milton Murdock Iv NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACOB MILTON MURDOCK IV (NPI 1124555461) is an individual student in an organized health care education/training program in Lakeside, California and active in the NPI registry since May 2017.

NPPES Registry Identity

NPI1124555461
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJACOB MILTON MURDOCK IV
Location Address12064 WOODSIDE AVE SUITE 105, SAN DIEGO CENTER FOR NEUROFEEDBACKLakeside, CA 92040
Mailing Address1106 2nd St, Ste 308Encinitas, CA 92024 · (760) 392-0033
Phone(619) 436-4263
Sole ProprietorNo
Enumeration DateMay 17, 2017
✔ NPI 1124555461 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
12064 WOODSIDE AVE SUITE 105, Lakeside, CA 92040
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacob Murdock's NPI number?

The NPI number for Jacob Murdock is 1124555461. It was assigned to this individual provider in the NPPES registry on May 17, 2017.

Where is Jacob Murdock located?

Jacob Murdock practices at 12064 Woodside Ave Suite 105 San Diego Center For Neurofeedback, Lakeside, CA 92040. The listed phone number is (619) 436-4263.

What is Jacob Murdock's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Jacob Murdock was last updated on May 17, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.