Active NPI
The Redwoods, a Community of Seniors
- Skilled Nursing Facility
- Mill Valley, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZR18499F | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Corporation
- 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 Seniors
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Apr 4, 2005
- Medicare certification status
- Active
- Certified beds
- 58
- Penalties (3 years)
- 3
National Provider Directory
National Provider DirectoryLocations
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Margaret Chu Lucaccini | Corporate Director | Jan 1, 2022 | |
| Burton Franklyn Miller | Corporate Director | Jan 1, 2024 | |
| Richard Ronald | Corporate Director | Jan 1, 2021 | |
| Kendra Pollack | Corporate Director | Jan 1, 2024 | |
| Laura Smith | Corporate Director | Jan 1, 2023 | |
| Daniel D Bikle | Corporate Director | Jan 1, 2019 | |
| Vera Meislin | Corporate Director | Jan 1, 2022 | |
| Brittany Jean Imwalle | Corporate Director | Jan 1, 2024 | |
| Peter Gordon | Corporate Director | Jan 1, 2021 | |
| Holly Yuo | Corporate Officer | Mar 18, 2024 | |
| Adp of the SNF | Mar 18, 2024 | ||
| The Redwoods, a Community of Seniors | Operational/Managerial Control | Dec 3, 1972 | |
| Adp of the SNF | Jan 28, 2025 | ||
| Elena Davidenko | Operational/Managerial Control | Sep 30, 2024 | |
| Adp of the SNF | Sep 30, 2024 | ||
| Janet Hines | Corporate Director | Jan 1, 2023 | |
| Kyle Ruth-Islas | Corporate Officer | Nov 14, 2022 | |
| Operational/Managerial Control | Nov 14, 2022 | ||
| Robert Reynolds | Corporate Director | Jan 1, 2020 | |
| Robert Harmon | Corporate Director | Jan 1, 2020 | |
| Dominic Joseph Picetti | Operational/Managerial Control | Oct 1, 2023 | |
| Adp of the SNF | Feb 7, 2025 | ||
| Caroline Joachim | Corporate Director | Jan 1, 2025 | |
| David Rand | Corporate Director | Jan 1, 2024 | |
| Andrea Flynn | Corporate Director | 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.
-
- Internal Medicine Physician
- Santa Rosa, CA
- NPI 1013413517
Adp of the SNF, Operational/Managerial Control
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- San Leandro, CA
- NPI 1023077294
-
- Internal Medicine Physician
- San Leandro, CA
- NPI 1457512360
-
- Internal Medicine Physician
- Corte Madera, CA
- NPI 1023028917
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2021; 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.