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Health Care Facility Licensing and Certification

 Contact Us

Phone: (916) 552-8632
Email:  CAB@cdph.ca.gov

For application status requests, please include the following in your email:
  • Name of Facility or Agency
  • License or Facility/Agency # (if applicable)
  • Address
  • Facility or Provider Type
  • Date Documentation Sent
  • Contact Number

Rural Health Clinic
Change of National Provider Identifier Application Packet

A clinic may be certified as a Rural Health Clinic (RHC). An RHC is "a clinic that is located in a rural area designated as a shortage area, is not a rehabilitation agency or a facility primarily for the care and treatment of mental diseases, and meets all other requirements, pursuant to Title 42 Code of Federal Regulations (CFR) section 491.2.

To report a change of National Provider Identifier (NPI), you must complete the required application packet. Refer to 42 CFR section 424.506 for information regarding NPI enrollment requirements.

How to Apply

An applicant must submit a completed application packet to the Centralized Applications Branch (CAB). The application packet contains the required forms in one location. The provider checklist identifies the required forms and supporting documents needed to apply for licensing and certification. The provider instructions are a resource to guide you through the process. The Sample Application Packet is a visual aid that displays a sample of the completed forms contained in the application packet.

Please refer to the following links to get started:

Where to Submit Application

Submit completed application packets to the CAB at the address listed below. Do not send any completed application packets, forms, or supporting documents to the local CDPH, District Office.

          California Department of Public Health
          Licensing and Certification Program
          Centralized Applications Branch
          P.O. Box 997377, MS 3207
          Sacramento, CA 95899-7377

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