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Click ‘Get Form’ to open the cdph 4470 in the editor.
Begin by entering your legal name as the practitioner in the designated field. Ensure accuracy for identification purposes.
Fill in your service site telephone number, FAX number, and email address. This information is crucial for communication.
Provide the business name of your employing entity along with your National Provider Identifier (NPI) number.
Complete personal details such as date of birth, gender, and social security number. Attach a copy of your social security card if required.
In section 8, input your practitioner’s license/certificate number and ensure to attach any necessary documentation.
Review all sections carefully before signing on page 4. Your signature confirms adherence to Family PACT Standards.

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What is the purpose of the CDPH?

The California Department of Public Health (CDPH) works to protect the publics health in the Golden State and helps shape positive health outcomes for individuals, families and communities.

What does CDPH stand for in California?

The California Department of Public Health (CDPH) works to protect the publics health and shape positive health outcomes for individuals, families and communities.

What is CDPH compliance?

CDPH Office of Compliance - Internal Audits The mission of the California Department of Public Health (CDPH), Office of Compliance - Internal Audits (OOC-Internal Audits) is to provide an independent, objective analysis and consulting services designed to add value and improve the Departments operations.

How long does it take for CDPH to approve a phlebotomy license?

The California Department of Public Healths Maternal, Child and Adolescent Health (MCAH) Division receives funding from the state budget and from the federal government to disburse to local health-related entities and others to promote better health of all mothers and children in California.