Guide

What Is a 104 NP in California? Independent Practice, and Its Real Limits

Summary

A 104 NP is a California nurse practitioner certified under Business and Professions Code §2837.104 to perform the §2837.103(c) functions without standardized procedures outside the six physician-staffed settings — a solo office, their own corporation, a house-call or telehealth practice. Eligibility stacks two periods: the 4,600-hour transition to practice, plus at least three further years of practice in good standing as a 103 NP.

By Gale · Updated 2026-07-31. Every figure cited to a dated source. How we write.

What Does the 104 Certificate Let You Do That the 103 Does Not?

It moves the same six functions outside the building. BPC §2837.104(a)(1) authorizes a certified 104 NP to perform the functions in §2837.103(c) "outside of the settings or organizations specified under subparagraphs (A) to (F)" of §2837.103(a)(2) 12. The BRN's own summary: a 104 NP "may work independently within the population focus of their National Certification" 3.

That is the whole delta. No new procedures, no broader prescriptive authority, no wider diagnostic license — only the removal of the requirement that a physician and surgeon practice where you practice. The side-by-side is at 103 vs. 104.

Two structural extras come with it. A 104 NP is eligible for membership of an organized medical staff, and a 104 NP member may vote at meetings of the department to which nurse practitioners are assigned — both subject to applicable conflict-of-interest policies of the bylaws (BPC §2837.104(a)(2)–(3)) 1. A 103 NP's voting right is materially narrower (BPC §2837.103(a)(3)(C)) 2.

What Are the Eligibility Requirements for 104 Certification?

Three, stacked, at BPC §2837.104(b) 1:

1. Meet every 103 requirement in §2837.103(a)(1) — national board examination, current accredited national certification, board-consistent education with clinical hours, and the California transition to practice of three full-time-equivalent years or 4,600 hours. 2. Hold an active California RN license plus a graduate degree — "a master's degree in nursing or in a clinical field related to nursing or a doctoral degree in nursing." 3. Practice as an NP in good standing for at least three years, "not inclusive of the transition to practice." The board may lower this at its discretion for an applicant holding a Doctor of Nursing Practice degree, based on practice experience gained in doctoral education.

The BRN operationalizes item 3 through 16 CCR 1482.4 as at least three full-time-equivalent years or 4,600 hours of direct patient care as a 103 NP in good standing — meaning a current, active, unrestricted license, with no probation, suspension or public reproval 3. Its 104 application instructions state the timing rule plainly: the start date of those hours "must be after obtaining designation of 103 NP" 4.

For DNP holders, the board asks that qualifying doctoral direct patient care be in the applicant's area of national certification, provided during the doctoral portion of the program, and not credited toward the master's degree 3.

When Did 104 Certification Actually Become Reachable?

The statute has read "Beginning January 1, 2023" since AB 890 1, but that date was unreachable in practice, because the three-years-as-a-103 requirement had to run first and the BRN did not create the 103 certificate until January 2023. The board said so on its own AB 890 page: because the law requires three years as a 103 first, "the Board is only able to certify 103 NPs at this time and will not be able to certify 104 NPs until 2026" 3.

That page has since been overtaken by events — the BRN now publishes a full step-by-step instruction packet for the 104 application, filed in BreEZe under "NP Independent Practice" 4. Older explainers that describe 104 status as a future thing are simply out of date. The dates, the screens and what the board asks for are in how to apply for 104 NP certification.

What Constrains a 104 NP Once Certified?

Four obligations replace the standardized-procedure apparatus, all in BPC §2837.104(c) 1.

Scope. You "shall not practice beyond the scope of their clinical and professional education and training, including specific areas of concentration" and shall practice "only within the limits of their knowledge and experience and national certification." Your certification's population focus is a real boundary, not a formality.

Consultation. You must consult and collaborate with other healing arts providers based on the patient's clinical condition. Physician consultation is mandatory in four situations: emergent conditions requiring prompt medical intervention after initial stabilizing care has started; a problem not resolving as anticipated after ongoing evaluation and management; history, physical or lab findings inconsistent with the clinical perspective; and upon request of the patient.

Referral plan. You must establish a plan for referral of complex medical cases and emergencies, specific to your practice area, with specific referral criteria addressing five categories: situations beyond your competence, scope or experience; patients failing to respond or acutely decompensating inconsistently with the disease course; any patient with a rare condition; conditions not fitting a commonly accepted diagnostic pattern; and all emergency situations after initial stabilizing care has begun.

Sole responsibility. Consultation with a physician and surgeon "alone shall not create a physician-patient relationship," and the nurse practitioner "shall be solely responsible for the services they provide." That is the trade this certificate makes. The full picture is in what replaces standardized procedures.

Can a 104 NP Own the Business?

This is where AB 890 stops and corporate law starts. BPC §2837.104(h) provides that "corporations and other artificial legal entities shall have no professional rights, privileges, or powers," with exceptions in subdivision (i) where the certificate is inactive, surrendered, revoked or restricted, or where the NP is employed under the BPC §2401 exemptions 1. California's corporate-practice-of-medicine doctrine is unchanged by AB 890.

The vehicle most NPs look at is the nursing corporation. Corporations Code §13401.5(f) permits physicians and surgeons, psychologists, physician assistants, LCSWs, LMFTs, optometrists, chiropractors, acupuncturists, naturopathic doctors, professional clinical counselors, podiatrists and licensed midwives to be shareholders, officers, directors or professional employees of a nursing corporation — but only so long as the sum of all shares owned by those licensed persons "does not exceed 49 percent of the total number of shares" 5. The nurse practitioner keeps the majority.

Payer enrollment is a separate track from BRN certification and does not travel with it; a new entity generally means new contracting, which is what credentialing and owning your insurance contracts cover. Gale, the practice OS this library belongs to, is built to run that track for independent clinicians.

None of the above is legal advice. Before forming an entity, signing an ownership agreement or structuring a management arrangement, confirm the specifics with a California health-law attorney.

What Obligations Carry Over From the 103?

The consumer-facing ones, essentially unchanged. A 104 NP not working under standardized procedures must inform all new patients, in a language understandable to the patient, that a nurse practitioner is not a physician and surgeon (BPC §2837.104(d)) 1, and must post a conspicuous notice naming the Board of Registered Nursing with its telephone number and website (BPC §2837.104(f)) 1 — the BRN specifies at least 48-point Arial and treats the patient notification as verbal 3. Professional liability insurance appropriate for the practice setting remains required (BPC §2837.104(g)) 1.

What is not required is a different disclosure that older explainers often merge with the first: a 104 NP "shall not be required by the board to tell a patient that the patient has a right to see a physician and surgeon" (BPC §2837.104(e)) 1. Saying you are not a physician remains mandatory; saying the patient may see one instead cannot be required of you. Both the notification and the posted notice survived SB 1451 — the posting duty was renumbered from subdivision (e) to (f) and gained the "not working under standardized procedures" qualifier, not repealed 1. The corrections page has the rest of what actually moved.

Common questions

At minimum, two stacked periods after nurse practitioner certification: a transition to practice of three full-time-equivalent years or 4,600 hours completed in California, then at least three further years of direct patient care in good standing as a 103 NP. The BRN's 104 instructions require the qualifying hours to start after 103 designation, so the periods cannot overlap.

No. BPC §2837.104(c)(1) confines a 104 NP to their clinical and professional education and training, including specific areas of concentration, and to the limits of their knowledge, experience and national certification. The BRN frames this as practicing independently within the population focus of the national certification.

Not a supervisory one, but a consultative one. BPC §2837.104(c)(2) requires physician consultation for emergent conditions after stabilizing care, unresolving problems, findings inconsistent with the clinical perspective, and on patient request. Section 2837.104(c)(4) separately requires a referral plan with specific criteria for complex cases and emergencies.

Within a cap. Corporations Code §13401.5(f) lets licensed physicians and surgeons, along with several other listed professions, hold shares or serve as officers, directors or professional employees of a nursing corporation, so long as all such licensed persons together own no more than 49 percent of the shares. BPC §2837.104(h) separately provides that corporations and other artificial legal entities have no professional rights, privileges or powers.

It changes what they see, not where they look. The BRN says an individual's authority to practice as a 103 NP or 104 NP displays along with registered nurse license status through the Department of Consumer Affairs License Search. No new initials or title were created for either category.

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References

  1. 1.California State Legislature (2024). Business and Professions Code § 2837.104 — Nurse practitioners: practice outside specified settings (amended by Stats. 2024, Ch. 481 (SB 1451), effective January 1, 2025). California Legislative Information (leginfo.legislature.ca.gov). link ✓BPC §2837.104(a) 'Beginning January 1, 2023'; (a)(1) authorizes the §2837.103(c) functions outside the six settings; (a)(2)–(3) medical staff membership eligibility and department voting subject to bylaws conflict-of-interest policies; (b)(1)–(3) eligibility, including 'a master's degree in nursing or in a clinical field related to nursing or a doctoral degree in nursing' and practice 'in good standing for at least three years, not inclusive of the transition to practice,' with board discretion to lower it for a DNP; (c)(1) scope limit; (c)(2)(A)–(D) the four mandatory physician-consultation circumstances; (c)(3) consultation creates no physician-patient relationship and the NP 'shall be solely responsible for the services they provide'; (c)(4)(A)–(E) the five required referral-plan criteria; (d),(e),(f),(g) notification, the no-longer-required right-to-see-a-physician statement, posted notice and liability insurance; (h)–(i) 'corporations and other artificial legal entities shall have no professional rights, privileges, or powers' and its exceptions.
  2. 2.California State Legislature (2024). Business and Professions Code § 2837.103 — Nurse practitioners: practice without standardized procedures (amended by Stats. 2024, Ch. 481 (SB 1451), effective January 1, 2025). California Legislative Information (leginfo.legislature.ca.gov). link ✓BPC §2837.103(c) supplies the six functions a 104 NP performs; §2837.103(a)(2)(A)–(F) supplies the six settings a 104 NP is authorized to work outside of; §2837.103(a)(3)(C) sets the narrower 103 NP voting right.
  3. 3.California Board of Registered Nursing (2026). Assembly Bill 890 — Nurse Practitioners: Scope of Practice: Practice Without Standardized Procedures (program page and frequently asked questions). California Board of Registered Nursing (rn.ca.gov). link ✓BRN AB 890 FAQ: a 104 NP 'may work independently within the population focus of their National Certification'; 16 CCR 1482.4 requires three full-time-equivalent years or 4,600 hours of direct patient care in good standing, 'good standing' meaning a current, active and unrestricted license not subject to probation, suspension or public reproval; DNP doctoral direct-patient-care hours count where in the area of national certification, provided during the doctoral portion and not credited to the master's degree; 'the Board is only able to certify 103 NPs at this time and will not be able to certify 104 NPs until 2026'; posted consumer notice in at least 48-point Arial plus verbal new-patient notification; 103/104 authority displays via DCA License Search; the Board chose not to create additional initials or title changes.
  4. 4.California Board of Registered Nursing (2026). Step by Step Guide for Applying for NP Independent Practice (104 NP). California Board of Registered Nursing (rn.ca.gov), applicant instruction packet. link ✓BRN 104 NP step-by-step instructions: the application is filed in BreEZe by selecting 'NP Independent Practice' under the Nurse Practitioner drop-down; 'The Start date of obtaining the 4,600 hours as a 104 NP must be after obtaining designation of 103 NP'; header note that the applicant 'has practiced as a Nurse Practitioner Group Setting without Standardized Procedures (103 NP) in good standing for at least three full-time equivalent years or 4,600 hours in direct patient care.'
  5. 5.California State Legislature (2022). Corporations Code § 13401.5 — Professional corporations: permitted licensed shareholders, officers, directors and professional employees (amended by Stats. 2022, Ch. 290 (AB 2671)). California Legislative Information (leginfo.legislature.ca.gov). link ✓Corporations Code §13401.5 permits the listed licensed persons to be shareholders, officers, directors or professional employees of the designated professional corporations 'so long as the sum of all shares owned by those licensed persons does not exceed 49 percent of the total number of shares of the professional corporation'; subdivision (f) designates the nursing corporation and lists licensed physicians and surgeons, podiatrists, psychologists, optometrists, LMFTs, LCSWs, physician assistants, chiropractors, acupuncturists, naturopathic doctors, professional clinical counselors and licensed midwives.

https://www.gale.care/for-providers/what-is-a-104-np-california · 5 sources. Competitor details are cited to dated public sources and maintained as they change; figures are estimates, not commitments. Synthetic demonstration.

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