Hla mus rau Cov Ntsiab Lus Tseem Ceeb​​ 

Ib Tus Neeg Saib Xyuas Neeg Mob (INP) Daim Ntawv Thov Kev Pab​​ 

  • Daim ntawv thov Medi-Cal tus kws kho mob, DHCS 6204 (tsis tas yuav sau npe)
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  • Medi-Cal Disclosure Statement, DHCS 6207 (tsis tas yuav sau ntawv sau)
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  • Daim ntawv cog lus Medi-Cal, DHCS 6208 (tsis tas yuav sau npe)
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  • Pov thawj ntawm National Provider Identifier (NPI):​​  NPE NPI Registry​​  Kev lees paub​​ 
  • Department of Consumer Affairs (DCA) Licence Printout​​ 
  • Siv tau State-Issued ID lossis Driver's License​​ 
  • Siv tau Basic Life Support (BLS) Certification​​ 
  • Kev lav phib xaub (kev ua tsis raug cai) kev pov hwm kev pov hwm​​ 
  • Rov pib dua. Piav qhia txog kev cob qhia thiab kev paub txog kev saib xyuas neeg mob rau cov neeg mob.​​ 
    Rau cov neeg thov LVN nkaus xwb: Muab lub npe ntawm RN uas yuav muab kev saib xyuas tsis tu ncua, nrog rau RN tus lej ntawv tso cai.
    Rau cov neeg thov RN nkaus xwb: suav nrog cov sij hawm ua haujlwm rau txhua txoj haujlwm tau teev tseg los ntawm tsib xyoos dhau los, piv txwv li, 40 teev hauv ib lub lis piam x 52 lub lis piam hauv ib xyoos = tag nrho cov sij hawm ua haujlwm hauv ib xyoos.​​ 

Xa daim ntawv thov ua tiav pob rau:​​ 

Department of Health Care Services​​ 

Integrated Systems of Care Division​​ 

Chaw Muab Npe Rau Npe​​ 

1501 Capitol Avenue, MS 4502​​ 

PO ib 997437​​ 

Sacramento, CA 95899-7437​​ 

THOV NCO NTSOOV: Xa pob khoom mus rau qhov chaw muab kev tso npe nkag​​  

TSIS TXAUS SIAB TXOJ CAI TXOJ CAI NTAWM TUS TSWV TSEV KAWM NTAWV​​ 

Yog tias koj muaj lus nug txog daim ntawv thov,​​  c​​ tag nrho (916) 552-9105, xaiv 5, ces xaiv 2.​​  Cov lus nug email tuaj yeem xa mus rau WaiveProEnroll@dhcs.ca.gov.​​ 
Hnub hloov tshiab kawg: 3/18/2025 2:58 PM​​