1. Home
  2. Directory
  3. California
  4. San Diego
  5. Military Health Care Provider
  6. NPI Profile

JAKE GARRETT THEOBALD
NPI 1053994327
Military Health Care Provider - Independent Duty Corpsman in San Diego, CA

Active since May 04, 2021
34101 FARENHOLT AVE, SAN DIEGO, CA 92134(619) 532-7968 Get Directions Write a Review

NPPES record last updated: December 3, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 3, 2021, May 4, 2021 (2 updates tracked since 2021).

About Jake Garrett Theobald NPPES

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

JAKE GARRETT THEOBALD (NPI 1053994327) is an individual independent duty corpsman provider in San Diego, California and active in the NPI registry since May 2021.

NPPES Registry Identity

NPI1053994327
Entity TypeIndividualMale
Primary Taxonomy1710I1002X
Provider Legal NameJAKE GARRETT THEOBALD
Location Address34101 FARENHOLT AVESan Diego, CA 92134-7000
Mailing Address303 Combine CtRichlands, NC 28574-6404 · (920) 287-1256
Phone(619) 532-7968
Sole ProprietorNo
Enumeration DateMay 4, 2021
Last NPPES UpdateDecember 3, 20212 updates tracked since enumeration
NPPES CertifiedDecember 3, 2021
✔ NPI 1053994327 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, San Diego, CA 92134
Open in Google Maps ↗

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.

CHRISTOPHER A WALLACE IDC
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE
SAN DIEGO, CA 92134
San Diego County (619) 532-7801
MR. GABRIEL A MICHAELS IDC
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE
SAN DIEGO, CA 92134
San Diego County (216) 701-4316
MR. GABRIEL JOSE SAN PEDRO IDC
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE
SAN DIEGO, CA 92134
San Diego County (619) 532-7968
ALEXANDER BOX
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE
SAN DIEGO, CA 92134
San Diego County (843) 605-3091
CHANTE ALLI MOORE
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE
SAN DIEGO, CA 92134
San Diego County (215) 681-7866
MR. STEVEN R CURRIER JR. SURFACE IDC
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE
SAN DIEGO, CA 92134
San Diego County (619) 532-7968
MARCO OLIVAREZ
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE
SAN DIEGO, CA 92134
San Diego County (619) 532-7968
MR. ANDREW BUD TAYLOR IDC
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE, BLDG 14
SAN DIEGO, CA 92134
San Diego County (619) 532-6233

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 Jake Theobald's NPI number?

The NPI number for Jake Theobald is 1053994327. It was assigned to this individual provider in the NPPES registry on May 4, 2021.

Where is Jake Theobald located?

Jake Theobald practices at 34101 Farenholt Ave, San Diego, CA 92134. The listed phone number is (619) 532-7968.

What is Jake Theobald'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 Jake Theobald was last updated on December 3, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.