Name Change/Change in Address of Record

Applicants: If you change your name and/or address of record after submitting an application for licensure, you must notify the Board immediately in order to receive current information.

Licensees: You are required by law (Business and Professions Code Section 136 and California Code of Regulations Section 1409.1) to notify the Board of any name changes or changes in address of record within 30 days of the change.

Change in Address of Record

You may submit changes in address of record to the Board by one of the following methods:

Name Change

You may submit name changes to the Board by one of the following methods:

For both methods, you must include a copy of legal documentation certifying the name change. For submissions online via BreEZe, you must upload the required documents to the online request. For submission via mail, you must provide copies of the required documents with the Notification of Name Change form.

Required documents include:

  1. A current government-issued photographic identification (e.g., driver license, alien registration, passport, etc.)

    AND

  2. One other form of legal documentation as proof of name change (e.g., certified court order, marriage certificate, dissolution of marriage)

If you require a replacement certificate as a result of a name change, please refer to our Duplicate Requests page for instructions.