Individual provider · Type 1 NPI
Tracy M. Hazelton, PA-C
Medical Physician Assistant · Clearlake, CA
NPI number
1821024746
Active
Practice location
14440 Olympic Drive
Clearlake, CA 95422-8809
Fax (707) 263-5019
Mailing address
PO Box 1950
Lakeport, CA 95453-1950
Other practice locations
- 925 Bevins Court, Lakeport, CA 95453-9754 · (707) 263-8383
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | PA13690 (CA) |
Medical Physician Assistant: Definition to come...
3 other providers at this address
Other medical physician assistant providers in Clearlake
About NPI 1821024746
Tracy M. Hazelton, PA-C's National Provider Identifier is 1821024746, issued on Jun 23, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Clearlake, CA. The record was last updated on Aug 1, 2025.