Primary Care Clinic - Mobile
Change of Service Application Packet
A State license is required to operate as a Primary Care Clinic Mobile Clinic (PCC-Mobile) in California. A mobile service unit or mobile unit means a special purpose commercial coach or a commercial coach that provides medical, diagnostic, and treatment services and does not mean a modular, relocatable, or transportable unit that is designed to be placed on a foundation when it reaches its destination, nor does it mean any entity that is exempt from licensure, pursuant to Health and Safety Code (HSC) section 1765.105.
To report a Change of Service, you must complete the required application packet. Refer to Title 22 of the California Code of Regulations section 75021 for information regarding application requirements. Refer to HSC sections 1200 through 1245 for licensure requirements. Refer to HSC sections 1765.101 through 1765.175 for information regarding Mobile Health Care Units.
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:
Application Packet Forms
Applicants must complete and submit the following forms in the application packet:
Where to Submit Applications
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