How to become a medical assistant, CNA or phlebotomy technician in California

The short answer

• Medical assistant: No state license and no state exam. You must be at least 18 and trained on the job or in a school program. Before you give injections or draw blood, you need at least 10 hours of training for each skill plus supervised practice. National certification is optional under state law, but some employers ask for it.
• Certified nurse assistant (CNA): You need a California Department of Public Health (CDPH) certificate: at least 160 hours in a CDPH-approved program (60 classroom, 100 clinical), a fingerprint background check and a two-part state exam. You can start at 16.
• Phlebotomy technician: Most people who draw blood and are not licensed clinicians need a CDPH certificate. The usual entry level, Certified Phlebotomy Technician I, requires 40 classroom hours, 40 clinical hours with at least 50 blood draws from a vein and 10 skin punctures, and a national exam.
• Whatever you choose, confirm that the program is approved by the right agency before you pay.

The three paths side by side

Medical assistant: no license, but firm rules on training and tasks

In California, a medical assistant is an unlicensed worker who does office work and simple, routine clinical tasks for a physician, podiatrist, physician assistant, nurse practitioner or certified nurse-midwife. For hands-on tasks, the supervising clinician generally must be physically present in the building. State law does not allow medical assistants to be hired for inpatient care in a general acute care hospital, so most jobs are in offices and clinics.

Two ways to train. Medical Board of California rules allow either:

• On-the-job training by a licensed physician or podiatrist, or by a registered nurse, licensed vocational nurse, physician assistant or qualified medical assistant working under a physician's or podiatrist's direction.
• A school program at a public high school or adult school, a community college, or a private school that is accredited by an agency the U.S. Department of Education recognizes or approved by the state Bureau for Private Postsecondary Education (BPPE).

Either way, the trainer must certify in writing what you were taught and that you showed you could do each task. You receive a certificate of completion, and each employer keeps a copy.

Minimum training for injections and blood draws. To give shots into muscle, under the skin or into the skin, or to do skin tests, you need at least 10 clock hours of training and must correctly perform at least 10 of each type of injection and 10 skin tests. Drawing blood needs its own 10 hours of training plus at least 10 venipunctures (needle draws from a vein) and 10 skin punctures. Training must cover anatomy, equipment, sterile technique, complications, emergency steps and California law. Giving inhaled medicine has a separate 10-hour rule.

What medical assistants may not do. The Medical Board says medical assistants may not start or disconnect an IV or give medicine into an IV line, insert a urinary catheter, do telephone triage on their own, give chemotherapy, inject collagen, use lasers for cosmetic treatments, or interpret test results. State law also does not authorize them to give local anesthetic. If a job posting lists these duties for a medical assistant, ask questions before you accept.

Certification is optional, but it can matter. The Medical Board recognizes five certifying organizations: the American Association of Medical Assistants (AAMA), American Medical Certification Association (AMCA), American Medical Technologists (AMT), California Certifying Board of Medical Assistants (CCBMA) and Multiskilled Medical Certification Institute (MMCI). Holding one of their certifications is one way to become a "qualified medical assistant," who may help train other medical assistants. Each organization sets its own eligibility rules. For example, the AAMA's exam is open to students and graduates of programs accredited by CAAHEP or ABHES (two national accrediting bodies), plus a few other groups. If you want a particular credential, check its eligibility rules and the program's accreditation before you enroll.

CNA: a state certificate with set hours and a two-part exam

1. Choose a CDPH-approved training program. Programs are run by nursing facilities, community colleges, adult schools and private schools. CDPH's CNA page links to its lists of approved programs. The classroom portion may be offered online if CDPH approved it, but an online program must arrange the clinical hours in a licensed nursing facility.
2. Complete at least 160 hours. State law requires at least 60 classroom hours and 100 hours of supervised clinical practice. Classroom time must include at least six hours on preventing, recognizing and reporting abuse, and time on dementia and developmental and mental disorders.
3. Apply and get fingerprinted when you enroll. You file the initial application (form CDPH 283B, which can be submitted online) and complete Live Scan fingerprinting before you have contact with residents. Under state law, a health facility that serves as a clinical training site must arrange and pay for trainees' Live Scan and Department of Justice processing, and may not pass that cost on to you.
4. Pass the competency exam. The knowledge test is either written (70 multiple-choice questions in two hours) or oral, for people who have trouble reading English. In the skills test, an evaluator watches you perform five randomly chosen skills. You must pass both parts, and the testing vendor gives you two years after finishing your course to do so. Federal rules guarantee at least three chances. State law also directed CDPH to seek, by the end of 2025, a vendor to offer the written and oral exam in Spanish; ask your program whether that option is available yet.
5. Receive your certificate. CDPH issues it after it has your application, your background clearance and your passing results. CDPH says to expect at least 30 days for your exam results to reach it from the testing vendor. Employers can check your status with CDPH's online lookup.

If you have a criminal record. State law says a conviction should not automatically bar certification, and CDPH reviews each case. It can deny certification for a conviction substantially related to the work if you have not shown rehabilitation, and it must weigh evidence such as how long ago the offense happened, completion of probation, a court dismissal of the conviction, your work history and references. If you are denied, you must get the reasons in writing, and you can request a hearing within 20 business days.

If you do not have a Social Security number. State law lets CNA applicants use an Individual Taxpayer Identification Number (ITIN) and bars CDPH from requiring disclosure of, or denying certification based solely on, citizenship or immigration status.

Keeping your certificate. A CNA certificate must be renewed every two years and expires on your birthday. Renewal requires 48 hours of in-service training (at least 12 in each year, and up to 24 online through an approved provider) and a criminal record clearance. If your certificate has been expired for more than two years, you must complete a 75-hour competency evaluation training program and pass the exam again.

Phlebotomy technician: three certificate levels from CDPH

CDPH's Laboratory Field Services (LFS) branch says that since April 9, 2003, people who draw blood in California must be certified unless they hold a California license, such as physician, nurse or clinical laboratory scientist, that already covers blood collection. CDPH's FAQ also says certified medical assistants can draw blood in a physician's office; under Medical Board rules, that requires the blood-draw training described above.

To qualify, you need proof of education: an official transcript showing graduation from an accredited U.S. high school, a passing score on the GED, HiSET or CHSPE, or college transcripts showing general education credit. Transcripts must come straight from the school. Transcripts from outside the U.S. need an evaluation from an LFS-approved evaluation service.

The national exam must come from an organization CDPH approves. As of October 21, 2026, CDPH lists the American Certification Agency (ACA), American Medical Certification Association (AMCA), American Medical Technologists (AMT), American Society for Clinical Pathology (ASCP), National Center for Competency Testing (NCCT/MMCI) and National Healthcareer Association (NHA). A national certification by itself does not let you work as a phlebotomist in California; you still need the CDPH certificate.

Applying and paying. You apply online through LFS and upload your training certificate, your clinical or experience documentation and your national certification. Fees are paid online, and the application fee is not refundable. A 2025 amendment set the base amount for each at $150, and state law allows the amounts to be adjusted every year, so check the current figure with LFS before you apply. State rules allow LFS up to 150 days to decide once an application is complete, so apply as soon as you qualify. The regulation lists a Social Security number as part of a complete application; if you have an ITIN instead, ask LFS before you pay for training.

Renewal. Starting January 1, 2026, CDPH is moving phlebotomy certificates to a one-year renewal cycle. Some cards issued in early 2026 still show a two-year date but must be renewed after one year; a certificate issued or renewed in 2025 that expires in 2027 keeps that date until then. Each renewal requires 3 hours of continuing education completed in the past year from an approved provider. Your employer must also document your competence at least once a year.

Work experience. CDPH says most unlicensed laboratory work in California does not count toward the experience routes, but blood draws done as a medical assistant in a physician's office or clinic that is not also a licensed testing laboratory can count. Blood bank work does not count.

Blood draws from an existing IV line. State law now lets certified phlebotomy technicians in licensed health facilities collect blood through an existing peripheral IV catheter (a short line placed in a vein), after at least three hours of facility training, under facility protocols and physician or registered nurse supervision. It does not allow them to start, stop or remove an IV, or to draw from central lines.

How to check a program before you pay

• Confirm approval with the agency that counts. CNA: CDPH's list of approved training programs. Phlebotomy: the approved phlebotomy training schools list on the LFS Training Programs page. Medical assistant: a public school, community college, accredited school or BPPE-approved school; if you want the AAMA credential, search the CAAHEP or ABHES directories.
• Look up any private school on BPPE's School Verification search, including its disciplinary actions. Some short, low-cost programs that take no state or federal student aid are exempt from BPPE approval. The state's Student Tuition Recovery Fund protects students of BPPE-approved schools.
• Ask for the School Performance Fact Sheet and the catalog before you sign. BPPE-approved schools must give you a fact sheet with completion rates, job placement rates, license exam pass rates where they apply, and salary information, along with how each figure was calculated.
• Get the total price in writing: tuition, registration, books, uniforms, supplies, background check, exam fees and state application fees. Ask which items are included.
• Ask who arranges your clinical hours or externship, where it happens, and whether a spot is guaranteed.
• For CNA programs, ask for the exam pass rate. To stay approved, a program must keep an average pass rate of at least 60 percent over two years.
• Know your cancellation rights. At a BPPE-approved school, if you cancel in writing by the first class session or the seventh day after enrollment, whichever is later, you get a full refund of institutional charges except a deposit or application fee of no more than $250. If you withdraw after completing 60 percent or less of the program, you are owed a prorated refund.
• Call two or three local employers and ask which programs they hire from.

Red flags:

• A "guaranteed" job or salary. The Federal Trade Commission warns that no school can guarantee you a job.
• Pressure to sign today, or no documents to read before you commit.
• A promise of a CNA or phlebotomy certificate "fully online." Both require in-person clinical practice.
• A claim that the school's own certificate, or a national exam alone, lets you work as a CNA or phlebotomy technician in California. Only CDPH issues those certificates.
• A charge for CNA training when you already work for, or have a job offer from, a nursing facility that takes Medicare or Medi-Cal (see below).

If something goes wrong at a private school, BPPE takes complaints, and its Office of Student Assistance and Relief can help at (888) 370-7589 (press 5).

Ways to lower the cost

• Nursing facility training. If you work for, or have a job offer from, a nursing facility that takes Medicare or Medi-Cal on the day you start a CNA program, federal rules say you cannot be charged for any part of the training or the competency exam, including textbooks. If you pay on your own and such a facility hires you within 12 months, the state must reimburse a share of your costs while you work there. State law also says facility training must happen during your normal working hours, or you must be paid for the extra time.
• On-the-job training. Medical Board rules allow employers to train medical assistants themselves. Ask employers whether they hire trainees.
• America's Job Center of California. These local centers offer free career help. Federal Workforce Innovation and Opportunity Act (WIOA) funds can pay for training at programs on the state's Eligible Training Provider List, and programs eligible for WIOA funding are marked in CalJOBS. Priority goes to people who receive public assistance, have low incomes or need basic skills help, and to veterans. Find a center through EDD's Office Locator or call the U.S. Department of Labor at 1-877-US-2JOBS (1-877-872-5627).
• If you receive unemployment benefits. EDD's California Training Benefits program may let you keep getting benefits without looking for work while you attend approved training. You must contact EDD before the sixteenth week of benefit payments. EDD does not pay tuition, books or supplies.
• Community colleges. The enrollment fee set in state law is $46 per unit per semester. The California College Promise Grant waives it for eligible students, including people who receive certain public assistance or meet income or financial-need standards; students who qualify under AB 540 can apply. Noncredit courses carry no enrollment fee. Books, uniforms and exam fees are extra, so also file the FAFSA or the California Dream Act Application.
• Workforce Pell. Starting with the 2026–27 award year, federal Pell Grants can cover some short job-training programs that last at least 8 but fewer than 15 weeks and run 150 to 599 clock hours, but only programs that the governor certifies and the U.S. Department of Education approves one by one. Ask the financial aid office whether a specific program qualifies; do not assume.

What these jobs pay in California

Federal estimates for California from May 2025 put the median hourly wage at $23.88 for medical assistants, $22.90 for nursing assistants and $26.94 for phlebotomists (about $49,660, $47,630 and $56,040 a year for full-time work). A median means half of workers earned more and half earned less, and it includes experienced workers, so starting pay is often lower and varies by region and employer. The federal nursing assistant category also includes aides who are not certified. Many health care employers must follow a separate state minimum wage schedule for health care workers; see California's health care worker minimum wage. The general rate for other jobs is explained in California minimum wage 2027.

Common questions

I trained in another state or country. Where do I start? For CNAs, CDPH has reciprocity and equivalency applications (form CDPH 283E). For phlebotomy, you must meet California's training, exam and education rules, and foreign transcripts need an approved evaluation. Medical assistants do not need a state credential, but each employer must keep a copy of your training certificate and your training must meet California's rules, so bring records showing what you were trained to do.

Which path should I pick? Think about the work you want. CNAs mostly help people with daily care such as bathing, moving and eating. Medical assistants mix front-office work with simple clinical tasks. Phlebotomy technicians focus on collecting blood samples. Many people later use one of these jobs as a step toward nursing or laboratory careers, so check the next program's prerequisites early.

For a wider look at how pay, training and retention shape this workforce, see The Direct-Care Workforce: Pay, Training, and Retention.

Sources

1. Medical Assistants — Medical Board of California, accessed October 21, 2026.
2. Business and Professions Code § 2069 — California Legislature (public.law reproduction of the official text), accessed October 21, 2026.
3. Business and Professions Code § 2070 — California Legislature (public.law reproduction), accessed October 21, 2026.
4. 16 CCR § 1366, Additional technical supportive services — Medical Board of California regulation (Legal Information Institute reproduction), accessed October 21, 2026.
5. 16 CCR § 1366.1, Training to perform venipuncture, injections and inhalation of medication — Medical Board of California regulation (LII reproduction), accessed October 21, 2026.
6. 16 CCR § 1366.3, Administration of training — Medical Board of California regulation (LII reproduction), accessed October 21, 2026.
7. CMA (AAMA) exam eligibility — American Association of Medical Assistants, accessed October 21, 2026.
8. Find an accredited program — Commission on Accreditation of Allied Health Education Programs, accessed October 21, 2026.
9. ABHES home page, with links to its directory of accredited institutions — Accrediting Bureau of Health Education Schools, accessed October 21, 2026.
10. Certified Nurse Assistant — California Department of Public Health, accessed October 21, 2026.
11. CNA initial application — California Department of Public Health, accessed October 21, 2026.
12. Health and Safety Code § 1337.1 — California Legislature (public.law reproduction), accessed October 22, 2026.
13. Criminal Record Review — California Department of Public Health, accessed October 22, 2026.
14. Health and Safety Code § 1337.2 — California Legislature (public.law reproduction), accessed October 21, 2026.
15. Health and Safety Code § 1337.3 — California Legislature (public.law reproduction; text as amended effective January 1, 2026), accessed October 21, 2026.
16. Health and Safety Code § 1337.5 — California Legislature (public.law reproduction), accessed October 21, 2026.
17. Health and Safety Code § 1337.6 — California Legislature (public.law reproduction), accessed October 21, 2026.
18. Health and Safety Code § 1337.9 — California Legislature (public.law reproduction), accessed October 21, 2026.
19. Health and Safety Code § 1338.5 — California Legislature (public.law reproduction), accessed October 21, 2026.
20. California nurse assistant exam overview — Credentia (state testing vendor), accessed October 21, 2026.
21. 42 CFR § 483.152, Requirements for approval of a nurse aide training and competency evaluation program — Centers for Medicare & Medicaid Services (eCFR, up to date as of October 20, 2026), accessed October 21, 2026.
22. 42 CFR § 483.154, Nurse aide competency evaluation — Centers for Medicare & Medicaid Services (eCFR), accessed October 21, 2026.
23. Phlebotomy Certificate — California Department of Public Health, Laboratory Field Services, accessed October 21, 2026.
24. Phlebotomy Certificate FAQs — CDPH Laboratory Field Services, accessed October 21, 2026.
25. Limited Phlebotomy Technician (LPT) Certificate — CDPH Laboratory Field Services, accessed October 21, 2026.
26. Approved Certifying Organization Examinations — CDPH Laboratory Field Services, accessed October 21, 2026.
27. Renewal of clinical laboratory personnel licenses and certificates — CDPH Laboratory Field Services, accessed October 21, 2026.
28. Training Programs — CDPH Laboratory Field Services, accessed October 21, 2026.
29. 17 CCR § 1030, Certification of phlebotomy technicians — CDPH regulation (LII reproduction), accessed October 21, 2026.
30. 17 CCR § 1031, Requirements and timeframes for applications — CDPH regulation (LII reproduction), accessed October 21, 2026.
31. 17 CCR § 1035, Phlebotomy training program requirements — CDPH regulation (LII reproduction), accessed October 21, 2026.
32. Business and Professions Code § 1246 — California Legislature (public.law reproduction; text as amended September 17, 2025), accessed October 21, 2026.
33. Business and Professions Code § 1300 and § 1300.1 — California Legislature (public.law reproductions; text as amended September 17, 2025), accessed October 21, 2026.
34. Student Resources — Bureau for Private Postsecondary Education, accessed October 21, 2026.
35. Student Tuition Recovery Fund — Bureau for Private Postsecondary Education, accessed October 21, 2026.
36. Education Code § 94874 — California Legislature (public.law reproduction), accessed October 21, 2026.
37. Education Code § 94910 — California Legislature (public.law reproduction; text effective January 1, 2026), accessed October 21, 2026.
38. Education Code § 94919 and § 94920 — California Legislature (public.law reproductions), accessed October 21, 2026.
39. Choosing a Vocational School or Certificate Program — Federal Trade Commission, last modified December 18, 2025; accessed October 21, 2026.
40. Eligible Training Provider List — California Employment Development Department, accessed October 21, 2026.
41. Find Training for You and Your Employees — California Employment Development Department, accessed October 21, 2026.
42. WIOA Adult Program — U.S. Department of Labor, Employment and Training Administration, accessed October 21, 2026.
43. Eligible Training Types for California Training Benefits — California Employment Development Department, accessed October 21, 2026.
44. Education Code § 76300 — California Legislature (public.law reproduction), accessed October 21, 2026.
45. California College Promise Grant Application, 2026–2027 — California Community Colleges Chancellor's Office, accessed October 21, 2026.
46. Frequently Asked Questions: Workforce Pell (as of October 2026) — U.S. Department of Education, Federal Student Aid, accessed October 21, 2026.
47. Occupational Employment and Wage Statistics tables (May 2025 state estimates) — U.S. Bureau of Labor Statistics; California medians for medical assistants, nursing assistants and phlebotomists retrieved through the BLS Public Data API on October 21, 2026.