The credentialing process ensures that all licensed advanced practice providers meet a minimum standard for credentials, privileges and performance standards.

Credentialing applications are submitted and reviewed by the Medical staff committee and in addition by Interdisciplinary practice committee for all Nurse Practitioners.

New applicants requesting credentialing and privileges must complete the application and turn in all related documents. Incomplete applications will not be processed.

Applications must include:

  1. Completed application for Allied Health Professional Membership
  2. Signed National Practitioner Data Bank form
  3. Signed Medical Staff Bylaws/Rules and Regulation form
  4. Department documents for NP’s or PA’s listed below
  5. Documents provided by Provider: Curriculum Vitae, NP/PA licenses,DEA license, CPR (BLS, ACLS, PALS, NALS)
  6. NPI number

Hiring department must supply

PA: Signed position description, signed delegation of services , UCD PA Practice agreement, Supervising MD responsibility for supervising PA, request for procedural privileges using APP standard protocols  with procedural logs

NP: Signed position description, Proctoring plan, Core standardized procedures that the provider will be working under and request for procedural privileges using APP standard protocols with procedural logs

Request for procedural privileges

Please note, advanced practice providers may not perform procedures that they are not privileged to perform. You must have a standard protocol approved, complete the proctoring process, supply procedure logs and request the privilege from the Interdisciplinary practice committee. Once approved, you may perform the procedure independently.

UC Davis Standardized Procedure for Core Privileges (PDF)