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:
  • 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: 
  • 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.