MICN

Effective Immediately!! Applications submitted during the last seven (7) calendar days of the month may be delayed due to Agency workflow. Applications will be processed as soon as workflow allows.

Download the Apllication form from the MICN documents and complete all steps required to become authorized as an MICN in the counties of Amador, Calaveras, Mariposa, and Stanislaus. 

The following outlines the steps to complete the initial authorization process.

  • Submit a completed and signed pdf application (151 KB) that includes:
  • Copies of:
  • MICN Course Completion Certificate
  • Current and valid California R.N. license, copies of both front and back
  • Current ACLS Certification (front and back)
  • Copy of photo identification (for example a California Drivers License)
  • Copy of your MCI Field Operations course CE Certificate (http://www.mvemsa.org), in compliance with Agency policy # 853.00
  • Payment of the $100.00 application fee
  • Take and pass with a minimum of 75%, the Regional MICN Authorization Exam
  • Take and pass with a minimum of 80%, the Regional ALS Treatment Protocol Exam
  • Satisfactorily complete 10 ALS Radio calls. These calls must be documented on the Regional ALS Radio Call Evaluation Form and evaluated by an authorized Base MICN or Base Physician working in a Base Hospital Emergency Department. You may not obtain your 10 ALS calls until you have passed the Regional MICN Authorization and Regional ALS Treatment Protocol exams.
  • An additional authorization requirement is to have one (1) years experience as an R.N. and six months experience in critical care or emergency department nursing.
  • Digital photo taken on site by Agency staff.

The following outlines the steps to complete the re-authorization process.

  • Submit a completed and signed pdf application (151 KB) that includes copies of:
    • Current and valid California R.N. license, copies of both front and back
    • Copy of photo identification (for example a California Drivers License)
    • Proof of successful completion of 16 hours of Continuing Education,  copies of CE Certificates must be submitted
    • Copy of your MCI Field Operations course CE Certificate (http://www.mvemsa.org) not dated earlier than 90 days prior to re-cert, in compliance with Agency policy # 853.00 
  • Payment of the $50.00 application fee
  • Digital photo taken on site by Agency staff
  • A late fee of $15 will be assessed for authorizations processed after the expiration date.

Once you have completed the above, please submit your application to our office. We will
review your application and issue authorization as appropriate. If you have further
questions regarding the MICN Authorization process, please feel free to contact MVEMSA at 209-529-
5085

Our Mission

"To ensure the appropriate provision of quality pre-hospital care services to the public in a cost effective manner as an integrated part of the overall health care system."

Providing the framework for quality emergency medical services to the citizens of Alpine, Amador, Calaveras, Mariposa, and Stanislaus Counties.

Contact Info

Mountain Valley EMS Agency

1101 Standiford Ave, Suite D1
Modesto, CA 95350

Tel: (209) 529-5085
Fax: (209) 529-1496

Office Hours

M-F 8:00am-4:30pm
Closed 12:00pm-1:00pm

Certifications

Monday: No Certification Processing
Tue-Thu: 8:00am – 4:30pm
Friday: 8:00am – 12:00pm
Closed 12:00pm-1:00pm (every day)