Gapasin Manor Icfddn #2

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

LTC80154F Issued in CA

Legal business name

GAPASIN MANOR ICFDDN #2

Practice address

2325 Stanfield Dr
Stockton, CA 95209-4017

Phone

(209) 474-2167

NPI assigned

May 10, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Violeta T Gapasin

Title

Owner

Phone

(209) 478-9400

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 05G965

Legal name

GAPASIN MANOR ICF DDN #2

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Mar 7, 1996

Last certification

Mar 20, 2025

Beds

6

Ownership / control type

Private (non-profit)

Facility address

2325 Stanfield Drive
Stockton, CA 95209

Tax ID family

Gapasin Manor Icfddn 13 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Gapasin Manor Icfddn #1

  • Intellectual Disabilities Intermediate Care Facility
  • Stockton, CA
  • NPI 1568676492
  NPD tax ID
• Gapasin Manor Icfddn #3

  • Intellectual Disabilities Intermediate Care Facility
  • Stockton, CA
  • NPI 1912111840
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207267200000",
    "number": "1194939025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 691581",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952691581",
            "telephone_number": "209-947-8940",
            "fax_number": "209-954-0387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 STANFIELD DR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952094017",
            "telephone_number": "209-474-2167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAPASIN MANOR ICFDDN #2",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2008-04-04",
        "status": "A",
        "authorized_official_last_name": "GAPASIN",
        "authorized_official_first_name": "VIOLETA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-478-9400",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "CA",
            "license": "LTC80154F",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Latoya Ganner
• Peter Gannon, MD
• Alanna Gantan
• Tanisha J Ganub
• Gapasin Manor Icfddn #1
• Gapasin Manor Icfddn #3
• Gapuz Incorporated
• Shayla Gapuz
• Alvaro R Garay, PA-C
• Peter Garbeff, MD

• Intellectual Disabilities Intermediate Care Facility in Stockton, CA
• Providers in Stockton, CA by specialty
• Intellectual Disabilities Intermediate Care Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.