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How to start a private practice in California

Going full-time is a big step. You're giving up a steady paycheck, and suddenly you're responsible for paperwork you were never trained to do.
This page walks through it in order. Take it one section at a time.

This is general business education, not legal, tax, or clinical advice. Rules change. Confirm with an attorney, CPA, or the BBS before you act.

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1. Associate / Pre-Licensed2. Side Practice3. Going Full-Time Solo4. Ready for Insurance5. Growing a Group

What full-time solo therapists usually worry about

  • "Can I actually afford to leave my agency job?"
  • "Am I setting up the business entity correctly?"
  • "Will the BBS or IRS come after me for something I missed?"
  • "Will clients be able to find my home address?"
  • "How do I get clients once the referrals from my old job stop?"

Step 1: Your business entity

In California, licensed clinicians generally must practice through a Professional Corporation, not an LLC. Many therapists file an LLC because it's what everyone else does, then learn it doesn't fit a licensed therapy practice. Some practice as a sole proprietor first. Confirm with a California business attorney before you file anything.

Step 2: Filings and registrations

  • BBS Fictitious Name Permit — generally required if you practice under a name other than your own legal name. Confirm current BBS rules.
  • EIN — a free federal tax ID from the IRS. Use it instead of your Social Security number on forms.
  • Separate business bank account — never mix practice and personal money.
  • City or county business license — requirements vary by location. Check with your city.
  • Statement of Information — corporations file this with the California Secretary of State, on a recurring schedule. Confirm deadlines with an attorney or CPA.
  • Type 1 vs. Type 2 NPI — a Type 1 NPI is for you as an individual clinician. A Type 2 NPI is for an organization, such as your professional corporation. Many solo practices end up with both, especially when billing insurance under the entity. Confirm which you need for each payer.

Step 3: HIPAA basics

  • Sign a BAA with every vendor that touches client information: EHR, phone, email, telehealth, billing.
  • Complete a security risk assessment and write down what you found and fixed.
  • Publish a Notice of Privacy Practices (NPP) and give it to clients.
  • Use a telehealth consent for clients you see by video.

Step 4: Intake paperwork

  • Informed consent for treatment
  • Financial policy — fees, payment timing, insurance responsibilities
  • Cancellation / late-cancel policy
  • Releases of information
  • Good Faith Estimate process for self-pay clients (No Surprises Act)

Most EHRs let you send these as digital intake packets.

Step 5: Fees, sliding scale, and break-even math

The question that keeps people in agency jobs is "Can I afford to leave?" Here's how to answer it with your own numbers instead of a guess.
Break-even math (fill in your own numbers):

  • What do you need to replace? Your current take-home pay, plus benefits you'll now pay for yourself (health insurance, retirement, paid time off).
  • What will the practice cost? Rent or office, EHR, malpractice, phone, directories, bookkeeping, licensing, continuing education.
  • What will taxes take? Ask a CPA for a realistic percentage to set aside.
  • What do you actually collect per session? Your fee or payer rate, minus no-shows and late cancels.
  • Divide: (Income to replace + practice costs + taxes) ÷ (collected per session) ÷ (weeks you'll actually work per year) = clients per week to break even.

That number tells you whether you can leave now, need a bridge (like a side practice first), or need a different payment model.
Sliding scale: If you offer one, put it in writing, apply it consistently, and decide in advance how many sliding-scale spots you can carry.

Step 6: Taxes now that nobody withholds

  • Quarterly estimated taxes — you'll generally owe federal and California estimated payments during the year. Confirm amounts and due dates with a CPA.
  • Set aside a percentage of every payment in a separate account.
  • When an S-Corp election makes sense — for some practices, once profit reaches a certain level, an S-Corp election can reduce taxes by paying yourself a reasonable salary plus distributions. It adds payroll and filing costs, so it doesn't make sense for everyone. Confirm with a CPA whether and when it fits you.

Step 7: Protect your privacy after filings go public

Once your NPI and entity filings are public, data broker sites often pick up your name and address. A data broker removal service can request removal on your behalf.

  • Incogni — Removes your personal info from data broker sites. For therapists who want their home address off people-search sites.
    https://incogni.cello.so/p9K3zLbNo6M
    Referral link: I may receive a referral reward if you sign up. It costs you nothing extra, and you get the same help from me either way.

Will clients find my home address? Your business address

A lot of places can publish your address:

  • California Secretary of State filings
  • Statement of Information
  • The NPI registry
  • Your BBS address of record
  • Insurer directories
  • Google
  • Your own website

If you work from home, get a professional address before you file anything. It's much easier than trying to remove your home address later.

Option A: Mailbox or registered agent address
  • Good for: receiving mail and some filings.
  • Not for: seeing clients.
  • Not eligible for a Google Business Profile.
Option B: A real shared therapy office with mail handling

A real office gives you a professional address you can actually use. You can see clients in person, it can strengthen credentialing applications, and it can support a Google Business Profile.
In Sacramento / Placer County: I offer West Roseville Counseling Offices at 1430 Blue Oaks Blvd, Roseville. Offices are furnished, and an on-site office manager handles mail securely. Plans range from the Flex Membership ($99/mo + $15/hr for rooms) to half-day and full-day leases.
https://westrosevillecounseling.com
West Roseville Counseling Offices is owned by Mason Anglin. I mention it because it solves this exact problem locally, but any compliant business address works.
Other options: a virtual mailbox or registered agent service (Option A), or any shared or subleased therapy office in your area that offers mail handling. Any compliant business address works.
Confirm with an attorney or CPA which address fits each filing.

Getting found online: your website

You have four main paths. Whichever you pick, own your domain name in your own account.

PathGood forTradeoffs
DIY website builder (e.g. Squarespace, Wix, SimplePractice website add-on)Fast and inexpensiveLimited control and SEO options
WordPress + hosting (e.g. Hostinger, SiteGround)Full control and strong SEOYou handle upkeep, updates, and security
Therapist-specific done-for-you (e.g. Brighter Vision, TherapySites)Easiest to get startedOngoing monthly cost, less flexibility
I build and host it for youDone for you, set up for Google and AI search from day oneScope discussed on a call

Links for builder, hosting, and done-for-you partners: [link TBD]

What your site needs
  • Who you help and what you treat
  • Your location, or "telehealth in California"
  • Your fees and the insurance you accept
  • A clear "Book a consultation" button
  • Your license type and number (confirm current BBS advertising rules)
  • Contact forms that are HIPAA-safe, or that clearly warn people not to share clinical details
Local SEO basics
  • One page per specialty, such as "Couples Therapy in [City]" or "Anxiety Therapy in [City]."
  • Page titles that match what people search.
  • Consistent NAP (name, address, phone) everywhere you're listed.
  • Directory profiles that link back to your site.

Google Business Profile

A Google Business Profile helps you show up on Google Maps and local search. It also has strict rules.

  • Eligibility: generally requires a real in-person location staffed during your stated hours, or a service area you travel to. Mail-only virtual offices and telehealth-only practices risk suspension.
  • A real shared office with actual in-person hours is stronger. Your listed hours must be real.
  • Working from home? You can set up as a service-area business and hide your address.
  • Setup: choose accurate categories, complete verification, and list your services.
  • Follow Google's current guidelines. They change.

Reviews:

  • You may not solicit reviews or testimonials from current clients.
  • When you reply to any review, never confirm or imply that the person is or was a client. Keep replies general.

Directories

  • Psychology Today first. It's still where many clients search.
  • Insurer directories once you're in-network.
  • Headway / Alma listings if you use a platform.
  • Psychology Today — Get 6 months free when you book a free call (request the invite on the intake form).
    Referral link: I may receive a referral reward if you sign up. It costs you nothing extra, and you get the same help from me either way.

Common expensive mistakes

  • Filing an LLC for a licensed therapy practice. Confirm the right entity with a California business attorney.
  • Using your home address on the NPI, Secretary of State filings, or Google.
  • Skipping BAAs with vendors.
  • Missing quarterly estimated taxes and getting a large bill plus penalties.
  • Electing S-Corp too early or too late without running the numbers with a CPA.
  • Using a mail-only address for Google Business Profile and getting suspended.
  • Asking current clients for reviews.
  • Building a website on a domain you don't own.

Tools that fit this stage

  • SimplePractice — EHR, notes, telehealth, intake packets.
    https://share.simplepractice.com/masonalmft7!70cc0ce288!a
    Referral link: I may receive a referral reward if you sign up. It costs you nothing extra, and you get the same help from me either way.
  • iPlum — HIPAA phone and texting on your own cell. What I use daily.
    [affiliate link TBD]
    Referral link: I may receive a referral reward if you sign up. It costs you nothing extra, and you get the same help from me either way.
  • Heard — Bookkeeping, quarterly taxes, S-Corp support. 30-day trial invite via the intake form.
    Referral link: I may receive a referral reward if you sign up. It costs you nothing extra, and you get the same help from me either way.
  • Gusto — Payroll, including your S-Corp salary.
    https://gusto.com/r/mason2de8523f
    Referral link: I may receive a referral reward if you sign up. It costs you nothing extra, and you get the same help from me either way.
  • Incogni — Data broker removal.
    https://incogni.cello.so/p9K3zLbNo6M
    Referral link: I may receive a referral reward if you sign up. It costs you nothing extra, and you get the same help from me either way.
  • West Roseville Counseling Offices — Professional address, mail handling, and in-person office space in Sacramento / Placer.
    https://westrosevillecounseling.com
    West Roseville Counseling Offices is owned by Mason Anglin. I mention it because it solves this exact problem locally, but any compliant business address works.
  • Psychology Today — 6 months free invite via the intake form.
    Referral link: I may receive a referral reward if you sign up. It costs you nothing extra, and you get the same help from me either way.

See all tools →

Leaving your agency job? Let's map it out.

Bring your numbers and your questions. We'll work through your break-even math, your setup order, and your next three actions.

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