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JACOB ANDERSON PROCTOR SFIDC
NPI 1467134692
Military Health Care Provider - Independent Duty Corpsman in San Diego, CA

Active since August 07, 2023
34101 FARENHOLT AVE BLDG 14, SAN DIEGO, CA 92134(619) 532-7968 Get Directions Write a Review

NPPES record last updated: August 7, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jacob Anderson Proctor Sfidc NPPES

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

JACOB ANDERSON PROCTOR SFIDC (NPI 1467134692) is an individual independent duty corpsman provider in San Diego, California and active in the NPI registry since August 2023.

NPPES Registry Identity

NPI1467134692
Entity TypeIndividualMale
Primary Taxonomy1710I1002X
Provider Legal NameJACOB ANDERSON PROCTORCredential: SFIDC
Location Address34101 FARENHOLT AVE BLDG 14San Diego, CA 92134-7000
Mailing Address34101 Farenholt Ave Bldg 14San Diego, CA 92134-7000 · (619) 532-7968
Phone(619) 532-7968
Sole ProprietorNo
Enumeration DateAugust 7, 2023
NPPES CertifiedAugust 7, 2023
✔ NPI 1467134692 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 Jacob Proctor's NPI number?

The NPI number for Jacob Proctor is 1467134692. It was assigned to this individual provider in the NPPES registry on August 7, 2023.

Where is Jacob Proctor located?

Jacob Proctor practices at 34101 Farenholt Ave Bldg 14, San Diego, CA 92134. The listed phone number is (619) 532-7968.

What is Jacob Proctor'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 Jacob Proctor was last updated on August 7, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.