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HEALTH CARE FACILITY LICENSING AND CERTIFICATIONā€‹ā€‹

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 Numberā€‹ā€‹ā€‹ā€‹ā€‹ā€‹ā€‹ā€‹
ā€‹

General Acute Care Hospitals and Acute Psychiatric Hospitals

License Consolidation

Required Documents

Online Application PDF Form
  • Embedded and generated by online system
Licensee/Business Entity Information 
  • Organizational chart displaying the following information: applicantā€™s owners, directors, board members, corporate officers, LLC members/managers, and partners 
    • The organizational chart needs to include all entities that have 5% or more direct and indirect ownership.ā€‹
Helpful Tip
  • ā€‹Submit a Change of Certification (CHOC) application to update Medi-Cal/Medicare, if applicable.



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