Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tracy M Hazelton, PA-C

Individual provider Medical Physician Assistant · NPI 1821024746

Tracy M Hazelton, PA-C is a Physician Assistant in Clearlake, California. Graduated from Stanford University School of Medicine in 1996, 30 years ago. Practices with Lake County Tribal Health Consortium Inc, a 42-clinician group and works from 2 locations. Licensed in California.

Years since qualifying
30
Trained at
Stanford University School of Medicine
Licensed in
CA
In the registry since
2006
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

14440 Olympic Dr
Clearlake, CA 95422-8809
Phone: (707) 263-8383
Fax: (707) 263-5019
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 925 Bevins Court, Lakeport, CA 95453-9754 — (707) 263-8383

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA13690 (CA)

Record details

NPI number1821024746
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 23, 2006
Last updated in NPPESAugust 1, 2025
Certification dateAugust 1, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolSTANFORD UNIVERSITY SCHOOL OF MEDICINE
Graduated 1996 (30 years in practice)
Group practice Lake County Tribal Health Consortium Inc — 42 clinicians
Accepts Medicare assignment Not indicated

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