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- California Physical Therapy Association (CPTA)
Address/Name Changes
Reporting Your Address of Record to the PTBC
Per Title 16, California Code of Regulations, Section 1398.6(a), licensees are required to report to the PTBC their residential address. An alternate address, such as a post office box or place of business, may be listed as your address of record. Your residential address will not be publicly disclosed if you prefer to use an alternate address. All PTBC mailings will be sent to your address of record and the same would be disclosed to the public with a written request from any interested party. Licensees are also required to report any subsequent address changes within 30 days of the change, confirming the new and old address as well as the date the address change took effect.
1398.6. Filing of Addresses
(a) Each licensee shall report to the board each and every change of residence address within 30 days after each change, giving both the old and new address. In addition to the address of residence, a licensee may provide the board with an alternate address of record. If an alternate address is the licensee's address of record, he or she may request that the residence address not be disclosed to the public.
How to Report your Address/Name Change
You can change your address online by selecting the Online Address Change below or you can download the Address/Name Change form to mail your changes to the PTBC. Name changes and request for duplicate wall/wallet licenses must be submitted to the PTBC by completing the required form below.

