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SANQUELA DEONA GRESHAM IDC
NPI 1043921711
Military Health Care Provider - Independent Duty Corpsman in San Diego, CA

Active since December 13, 2022
34101 FARENHOLT AVE BLDG 14, SAN DIEGO, CA 92134(706) 990-9926 Get Directions Write a Review

NPPES record last updated: May 25, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 25, 2023, Dec 13, 2022 (2 updates tracked since 2022).

About Sanquela Deona Gresham Idc NPPES

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

SANQUELA DEONA GRESHAM IDC (NPI 1043921711) is an individual independent duty corpsman provider in San Diego, California and active in the NPI registry since December 2022.

NPPES Registry Identity

NPI1043921711
Entity TypeIndividualFemale
Primary Taxonomy1710I1002X
Provider Legal NameSANQUELA DEONA GRESHAMCredential: IDC
Location Address34101 FARENHOLT AVE BLDG 14San Diego, CA 92134-7000
Mailing Address5264 Beachfront Cove St Unit 217San Diego, CA 92154-5251 · (706) 990-9926
Phone(706) 990-9926
Sole ProprietorNo
Enumeration DateDecember 13, 2022
Last NPPES UpdateMay 25, 20232 updates tracked since enumeration
NPPES CertifiedMay 25, 2023
✔ NPI 1043921711 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMilitary Health Care Provider · Independent Duty CorpsmanOther Service Providers
Taxonomy Code1710I1002X
Definition

A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.

34101 FARENHOLT AVE BLDG 14, San Diego, CA 92134
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. MICHAEL WILLIAM ASHLINE IDC
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
San Diego County (619) 532-6195
MR. ROBERT LUND IDC
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
San Diego County (864) 201-6478
JOHN DAVID MACLEOD
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
San Diego County (716) 955-9805
STEVEN LE IDC
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
San Diego County (619) 532-7968
WILLIAM ALLEN IRISH IDC
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
APO, AP 92134
San Diego County (619) 532-6195
TIMOTHY JOHN RUANE IDC
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
San Diego County (619) 532-7968
OLIVIA KROHTA
Student in an Organized Health Care Education/Training Program
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
San Diego County (619) 532-7968
JARED MICHAEL O'BRIEN
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
San Diego County (619) 532-7968

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 Sanquela Gresham's NPI number?

The NPI number for Sanquela Gresham is 1043921711. It was assigned to this individual provider in the NPPES registry on December 13, 2022.

Where is Sanquela Gresham located?

Sanquela Gresham practices at 34101 Farenholt Ave Bldg 14, San Diego, CA 92134. The listed phone number is (706) 990-9926.

What is Sanquela Gresham's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

When was this NPI record last updated?

The NPPES record for Sanquela Gresham was last updated on May 25, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.