Fulton Gardens Post Acute LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

FULTON GARDENS POST ACUTE LLC

Practice address

537 E Fulton St
Stockton, CA 95204-2227

Phone

(209) 466-2066

Fax

(209) 466-5945

NPI assigned

Apr 17, 2019

Last updated

May 2, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jose Lynch

Title

Manager

Phone

(714) 673-6810

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1629631312. Details of each certification follow.

• CCN 055833 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 055833

Legal name

FULTON GARDENS POST ACUTE, LLC

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Nov 6, 1967

Last certification

Jan 10, 2025

Beds

116

Ownership / control type

Limited Liability Corporation

Organization structure

LLCProprietary

Incorporated

Feb 21, 2019 in CA

Enrollment address

537 E Fulton Street
Stockton, CA 95204-2227

Nursing home name

FULTON GARDENS POST ACUTE, LLC

Listed as

Fulton Gardens Post Acute, LLCCCN 055833 · All quality measures

Overall star rating

3 of 5

Health inspections

3 of 5

Staffing

4 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Nov 6, 1967

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

116106.0 residents per day on average

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Mariam Lotia

  • Hospitalist Physician
  • Stockton, CA
  • NPI 1437599065

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 4

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• Desert Canyon Post Acute, LLC

  • Skilled Nursing Facility
  • Lancaster, CA
  • NPI 1912403718

  Abby GL LLC

  CMS ownership
• Desert Ridge Transitional Care Center, LP

  • Skilled Nursing Facility
  • Victorville, CA
  • NPI 1043837966

  Abby GL LLC

  CMS ownership
• The Care Center on Hazeltine LLC

  • Skilled Nursing Facility
  • Van Nuys, CA
  • NPI 1831752377

  Abby GL LLC

  CMS ownership
• Thousand Oaks Post Acute, LLC

  • Skilled Nursing Facility
  • Thousand Oaks, CA
  • NPI 1508327446

  Abby GL LLC

  CMS ownership

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Mariam Lotia

  • Hospitalist Physician
  • Stockton, CA
  • NPI 1437599065

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1555459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651449600000",
    "number": "1629631312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 EXCHANGE STE 140",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926021343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "537 E FULTON ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952042227",
            "telephone_number": "209-466-2066",
            "fax_number": "209-466-5945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULTON GARDENS POST ACUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-17",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A",
        "authorized_official_last_name": "LYNCH",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "714-673-6810"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "284 Merchant St",
            "city": "Ste Genevieve",
            "state": "MO",
            "country_code": "US",
            "postal_code": "636701610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• John Kiyoshi Fujii, O.D.
• James Fullard
• Cynthia Fullwood-Fleck, MFT, PCC
• Desiree L Fultcher
• Kimberly Monice Fultcher
• Miguel Angel Fulton
• Jack Leonard Funamura, M.D.
• Janwyn Loy Funamura, M.D.
• Rebecca Kaye Fundenberger
• Cristina Funghi, MD

• Skilled Nursing Facility in Stockton, CA
• Providers in Stockton, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.