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Contra Costa County Mental HealthCREDENTIALING/PRIVILEGING FORM
SEND TO: Mental Health Administration 1340 Arnold Dr., #200, Martinez, CA 94553
FAX (Provider Services): (925) 9575217
EMAIL: Provider.
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The privileging form rev12-14-17doc is required by individuals who need to apply for or update their professional privileges in a medical or healthcare setting. This may include healthcare practitioners, physicians, nurses, technicians, or any other healthcare professionals seeking appropriate privileges within a specific organization or institution. The form acts as a comprehensive documentation of their qualifications, skills, and experience, which is necessary for evaluating and determining their eligibility for specific privileges.
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