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Get CA CDPH 512 2014-2024

) 552-8780 FAX: (916) 552-8777 NHAP@cdph.ca.gov LICENSE RENEWAL AFFIDAVIT FOR NURSING HOME ADMINISTRATORS Please complete and return License Renewal Affidavit to NHAP. NHA LICENSE NO. LICENSE STATUS CHANGE REQUESTS AND LICENSE RENEWAL FEES For a current fee list, please visit our website at: www.cdph.ca.gov/certlic/occupations/Pages/NursingHomeAdministrator.aspx. PLEASE NOTE ACTIVE INACTIVE If your license has been expired for two (2) or more years, please contact the NHAP office at (916) 5.

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