Provider Services
For accessibility issues, please contact Provider Services at 925-608-6790.
Directory
Provider Manual
Informing Materials (English/Spanish)
They are also available in Braille and audio. Call Access Line at 1-888-678-7277.
- Beneficiary Handbook | Spanish
- (Large Print-English | Spanish) - MHA58 - Beneficiary Grievance Review Request Form | Spanish
- (Large Print-English | Spanish) - MHA56 - Appeal or Expedited Appeal Request Form | Spanish
- (Large Print-English | Spanish) - MHA54 - Beneficiary Request for Change of Provider Form | Spanish
- (Large Print-English | Spanish) - MHA52 - Beneficiary Suggestion Form | Spanish
- (Large Print-English | Spanish) - Advance Directive | Spanish
- (Large Print-English | Spanish) - Continuity of Care | Spanish
- (Large Print-English | Spanish)
Posters (English/Spanish)
- Beneficiary Rights:
- Letter size (English | Spanish)
- Ledger size (English | Spanish)
- Grievance/Change of Provider/Appeal:
- Letter size (English | Spanish)
- Ledger size (English | Spanish)
- Informing Materials poster:
- Letter size (English | Spanish)
- Legal size (English | Spanish)
Credentialing and Recredentialing
- Help Sheet
- Quick Reference Guide
- Application Checklist
- Taxonomy Codes
- NPI Registration & Taxonomy Alterations
- NPI Registration Changes
- MHA12 - ShareCare ID Request Form
- MHA22 - Credentialing/Privileging Form
- MHA22a - Facility Change Form
- MHA22b - Recredentialing Application
- MHA22c - SSN Consent Form
- MHA22d - Staff Termination Form
- MHA22e - Facility/Program Assignment Form
- MHA22f - Legal Name Change Form
- Sample Provider Signature Sheet
Scope of Practice
Certification/Re-certification
- SD/MC Provider Certification & Re-certification Protocol
- SD/MC Provider Certification & Re-certification Site Visit Preparation Guide
- CCMHP Individual/Group Site Review
PAVE and Medi-Cal Rx Enrollment
- PAVE Step-by-Step Guide
- NPI Registration and Alterations
- Medi-Cal Rx Step-by-Step Guide
- How to Update Primary Practice Address on NPPES
- Frequently Asked Questions