MEMBERSHIP AND CREDENTIALING

Application Packets for Humboldt IPA Membership and Credentialing

Physician Application Packet (MD, DO)
 

To use the packets below, right-click the link and choose “Save as…” and save a copy to your computer. Then browse to the saved location to open the file. If you need a PDF viewer you can download the free Adobe Reader here: https://get.adobe.com/reader/

Podiatrist Application Packet (DPM)
Acupuncturist Application Packet (LAC)
Behavioral Health Professional Application Packet (PSY, PhD, MFT, LCSW)
Chiropractor Application Packet (DC)
Physical Therapist/Occupational Therapist Application Packet (PT/OT)
Speech Therapist/Audiologist Application Packet (SLP/AUD)
Nurse Practitioner/Physician Assistant/Certified Nurse Midwife/Certified RN Anesthetist Application Packet  (NP/PA/CNM/CRNA)

*Note: If you receive an error stating “To view the flash technology content in this pdf file…”, then please Click Here and choose “Run” to install a version of Adobe’s Flash player that will allow you to open the file.

If you have questions or need additional information, please contact Humboldt IPA Credentialing Manager, Genia Garibaldi, at 707.267.9577 or