The Humboldt IPA is a delegated physician group including non-physician providers for HMO health plans as well as a third-party administrator for local employer PPO health plans. By credentialing with the Humboldt IPA network, you will become a participating provider for members of the following health plans:
- Anthem Blue Cross HMO
- Blue Shield HMO (except for Behavioral Health Professionals)
- Blue Lake Rancheria PPO Health Plan
- Humboldt IPA Employee Assistance Program (EAP)
Please note:
- Applications are best viewed using Internet Explorer.
- A PDF viewer is required. If you need a PDF viewer you can download the free Adobe Reader here: https://get.adobe.com/reader/
- A CAQH application is required for Behavioral Health Professionals who wish to join the Anthem Blue Cross network. CAQH is a free application for providers. Find the CAQH application and additional information here: https://proview.caqh.org/pr
- A California Participating Practitioner Application (CPPA) or Council for Affordable Quality Healthcare (CAQH) Application may be substituted in place of an IPA-provided application
MD /DO Credentialing Application:
Non-stockholder Physician Application Packet
Stockholder Physician Application Packet (optional)
All Other Credentialing Applications:
Acupuncturist Application Packet (LAC)
Behavioral Health Professional Application Packet (PSY, PhD, MFT, LCSW)
Chiropractor Application Packet (DC)
Optometrist Application Packet (OD)
Physical Therapist/Occupational Therapist Application Packet (PT/OT)
Podiatrist Application Packet (DPM)
Nurse Practitioner/Physician Assistant/Certified Nurse Midwife (NP/PA/CNM)
Speech Therapist/Audiologist Application Packet (SLP/AUD)
If you have questions or need assistance, please contact the Humboldt IPA Credentialing Manager, Danielle Cook, at 707.443.4563 ext. 129 or Email.
