Get the free CHDP Provider Information Notice No.. CHDP Provider Information Notice No.
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State of CaliforniaHealth and Human Services Agency Department of Health Care Services JENNIFER KENT DIRECTOR EDMUND G. BROWN JR. GOVERNOR May 1, 2017, CHIP Provider Information Notice No.: 1702 TO:
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What is chdp provider information notice?
The CHDP provider information notice is a form used to report provider information related to the Child Health and Disability Prevention (CHDP) Program.
Who is required to file chdp provider information notice?
Health care providers participating in the CHDP Program are required to file the provider information notice.
How to fill out chdp provider information notice?
The provider information notice must be filled out with accurate information about the participating health care provider and submitted to the appropriate entity.
What is the purpose of chdp provider information notice?
The purpose of the provider information notice is to ensure that accurate information regarding participating health care providers is on record for the CHDP Program.
What information must be reported on chdp provider information notice?
Information such as the provider's name, contact information, services provided, and any changes in provider status must be reported on the notice.
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