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PROVIDENCE REDWOOD MEMORIAL HOSPITAL
NPI 1285849026
General Acute Care Hospital - Critical Access in Fortuna, CA

Active since May 14, 2007CLIA 05D0613039 · Accreditation
3300 RENNER DR, FORTUNA, CA 95540(707) 725-3361(707) 725-7212 Get Directions Write a Review

NPPES record last updated: June 22, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 22, 2021, Aug 9, 2018 (2 updates tracked since 2018).

About Providence Redwood Memorial Hospital NPPES

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

PROVIDENCE REDWOOD MEMORIAL HOSPITAL (NPI 1285849026) is a healthcare organization registered as a critical access in Fortuna, California and active in the NPI registry since May 2007. The organization holds an CLIA Accreditation certificate valid through January 2, 2027 and lists Donald Wayne Anderson, Assistant Secretary For Enrollment, as its authorized official.

NPPES Registry Identity

NPI1285849026
Entity TypeOrganization
Primary Taxonomy282NC0060X
Legal Business NameST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC
Location Address3300 RENNER DRFortuna, CA 95540
Mailing Address3300 Renner DrFortuna, CA 95540-3120 · (707) 725-3361 · Fax (707) 725-7212
Phone(707) 725-3361
Fax(707) 725-7212
Organization SubpartYesParent: St. Joseph Health System
Authorized OfficialDonald Wayne AndersonAssistant Secretary For Enrollment · (425) 525-5392
Enumeration DateMay 14, 2007
Last NPPES UpdateJune 22, 20212 updates tracked since enumeration
NPPES CertifiedJune 22, 2021
✔ NPI 1285849026 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral Acute Care Hospital · Critical AccessHospitals
Taxonomy Code282NC0060X
License✔ Licensed in CA · 110000173
3300 RENNER DR, Fortuna, CA 95540
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Other Names 1

Doing Business AsProvidence Redwood Memorial Hospital

Other Identifiers 1

Medicaid1285849026CA

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 05D0613039

Providence Redwood Memorial Hospital Laboratory · Fortuna, CA
Active · expires Jan 2, 2027
CLIA Number05D0613039
Laboratory TypeHospital
Certificate Effective DateJanuary 3, 2025
Certificate Expiration DateJanuary 2, 2027
Laboratory DirectorRachel E. Donohue
Laboratory Phone(707) 445-8121
Laboratory LocationProvidence Redwood Memorial Hospital Laboratory3300 Renner Dr, Fortuna, CA 95540
CLIA data matches this NPI record on: Address Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

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.

STEPHANIE L DEMARA M.D.
Anesthesiology
3300 RENNER DR
FORTUNA, CA 95540
Humboldt County (707) 725-3611
DR. WILLIAM M FRENCH M.D.
Radiology (Diagnostic Radiology)
3300 RENNER DR
FORTUNA, CA 95540
Humboldt County (707) 725-3361
ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC
General Acute Care Hospital (Critical Access)
3300 RENNER DR
FORTUNA, CA 95540
Humboldt County (707) 725-3361
ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC
Pharmacy
3300 RENNER DR
FORTUNA, CA 95540
Humboldt County (707) 725-7332
ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC
General Acute Care Hospital (Critical Access)
3300 RENNER DR
FORTUNA, CA 95540
Humboldt County (707) 725-3361
MIAE LEE CRNA
Anesthesiology
3300 RENNER DR
FORTUNA, CA 95540
Humboldt County (707) 725-3361
D. PETER GOLDBERG M.D.
Anesthesiology
3300 RENNER DR
FORTUNA, CA 95540
Humboldt County (707) 725-3361
DR. CASSANDRA ANN KENNEDY M.D.
Surgery
3300 RENNER DR
FORTUNA, CA 95540
Humboldt County (707) 725-9832

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 St. Joseph Health Northern California, LLC's NPI number?

The NPI number for St. Joseph Health Northern California, LLC is 1285849026. It was assigned to this organization in the NPPES registry on May 14, 2007. The provider is doing business as Providence Redwood Memorial Hospital.

Where is St. Joseph Health Northern California, LLC located?

St. Joseph Health Northern California, LLC is located at 3300 Renner Dr, Fortuna, CA 95540. The listed phone number is (707) 725-3361.

What is St. Joseph Health Northern California, LLC's specialty?

The primary specialty registered for this NPI is General Acute Care Hospital, specializing in Critical Access, with taxonomy code 282NC0060X.

Does St. Joseph Health Northern California, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 05D0613039) is associated with this NPI, valid through January 2, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for St. Joseph Health Northern California, LLC was last updated on June 22, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.