Organization Active NPI

The Redwoods, a Community of Seniors

  • Skilled Nursing Facility
  • Mill Valley, CA
National Provider Identifier
1205809381
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
THE REDWOODS, A COMMUNITY OF SENIORS
Practice address
40 Camino Alto
Mill Valley, CA 94941
Phone
(415) 383-2741
Fax
(415) 373-0115
NPI assigned
Feb 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

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

Authorized official

Name
Lynette Clark
Title
Cfo
Phone
(415) 383-2741

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X CA Primary

Addresses

Primary practice location

40 Camino Alto
Mill Valley, CA 94941

Mailing address

40 Camino Alto
Mill Valley, CA 94941-2956
Phone (415) 383-2741

Other identifiers 1

IdentifierTypeStateIssuer
ZZR18499FMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050301000103 CA Part A Provider - Skilled Nursing Facility 6204889421 Practice locations: Mill Valley, CA

Skilled nursing facility certification: CCN 555826

Legal name
THE REDWOODS, A COMMUNITY OF SENIORS
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 4, 2005
Last certification
Jul 12, 2024
Beds
58
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Dec 3, 1970 in CA
Enrollment address
40 Camino Alto
Ofc
Mill Valley, CA 94941-2997
Nursing home name
THE REDWOODS, A COMMUNITY OF SENIORS

Care Compare: Nursing home

Medicare Care Compare
Listed as
The Redwoods, a Community of SeniorsCCN 555826
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Apr 4, 2005
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5843.4 residents per day on average
Penalties (3 years)
3Fines totaling $103,054

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations

40 Camino Alto
Ofc
Mill Valley, CA 94941
Phone (415) 383-2741

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Margaret Chu Lucaccini Individual Corporate DirectorBoard Member Jan 1, 2022
Burton Franklyn Miller Individual Corporate DirectorBoard Member Jan 1, 2024
Richard Ronald Individual Corporate DirectorTreasurer Jan 1, 2021
Kendra Pollack Individual Corporate DirectorBoard Member Jan 1, 2024
Laura Smith Individual Corporate DirectorSecretary Jan 1, 2023
Daniel D Bikle Individual Corporate DirectorBoard Member Jan 1, 2019
Vera Meislin Individual Corporate DirectorBoard Member Jan 1, 2022
Brittany Jean Imwalle Individual Corporate DirectorBoard Member Jan 1, 2024
Peter Gordon Individual Corporate DirectorBoard Member Jan 1, 2021
Holly Yuo Individual Corporate OfficerChief Financial Officer Mar 18, 2024
Adp of the SNF Mar 18, 2024
The Redwoods, a Community of Seniors Organization, Mill Valley, CA Non-profit Operational/Managerial Control Dec 3, 1972
Adp of the SNF Jan 28, 2025
Elena Davidenko Individual Operational/Managerial Control Sep 30, 2024
Adp of the SNF Sep 30, 2024
Janet Hines Individual Corporate DirectorPresident of Board Jan 1, 2023
Kyle Ruth-Islas Individual Corporate OfficerChief Executive Officer Nov 14, 2022
Operational/Managerial Control Nov 14, 2022
Robert Reynolds Individual Corporate DirectorBoard Member Jan 1, 2020
Robert Harmon Individual Corporate DirectorBoard Member Jan 1, 2020
Dominic Joseph Picetti Individual Operational/Managerial Control Oct 1, 2023
Adp of the SNF Feb 7, 2025
Caroline Joachim Individual Corporate DirectorBoard Member Jan 1, 2025
David Rand Individual Corporate DirectorBoard Member Jan 1, 2024
Andrea Flynn Individual Corporate DirectorBoard Member Jan 1, 2023

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609718400000",
    "number": "1205809381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 CAMINO ALTO",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949412956",
            "telephone_number": "415-383-2741",
            "fax_number": "415-383-4768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 CAMINO ALTO",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "94941",
            "telephone_number": "415-383-2741",
            "fax_number": "415-373-0115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE REDWOODS, A COMMUNITY OF SENIORS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-09",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "LYNETTE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "415-383-2741"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZR18499F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Valley, CA

Sources for this page

Verify at the official NPI Registry.