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Individual

TRACY M HAZELTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
14440 OLYMPIC DRIVE, CLEARLAKE, CA 95422-8809
(707) 263-8383
(707) 263-5019
Mailing address
PO BOX 1950, LAKEPORT, CA 95453-1950
(707) 263-8382
(707) 263-1909

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA13690
CA

Other

Enumeration date
06/23/2006
Last updated
08/01/2025
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