Individual provider Active NPI

Tracy Martinez Rolon

  • Clinical Social Worker
  • Pomona, CA
National Provider Identifier
1992310726
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW129816 Issued in CA
Practice address
790 E Bonita Ave
Pomona, CA 91767-1906
Phone
(909) 625-7207
NPI assigned
Sep 9, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X ASW109669 CA
Social Worker 104100000X ASW109669 CA
Case Manager/Care Coordinator 171M00000X
Student in an Organized Health Care Education/Training Program 390200000X CA
Clinical Social Worker 1041C0700X LCSW129816 CA Primary

Addresses

Primary practice location

790 E Bonita Ave
Pomona, CA 91767-1906

Mailing address

790 E Bonita Ave
Pomona, CA 91767-1906
Phone (909) 625-7207

Other practice location 1

855 N Euclid Ave
Ontario, CA 91762-2729
Phone (562) 206-9064

Other practice location 2

902 S Myrtle Ave
Monrovia, CA 91016-3427
Phone (626) 357-3258

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ASW109669CAMDMental Health Counselor
LCSW129816CAMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1992310726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 E BONITA AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917671906",
            "telephone_number": "909-625-7207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 E BONITA AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917671906",
            "telephone_number": "909-625-7207"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "855 N Euclid Ave",
            "address_purpose": "LOCATION",
            "city": "Ontario",
            "state": "CA",
            "postal_code": "917622729",
            "country_code": "US",
            "telephone_number": "562-206-9064",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "902 S Myrtle Ave",
            "address_purpose": "LOCATION",
            "city": "Monrovia",
            "state": "CA",
            "postal_code": "910163427",
            "country_code": "US",
            "telephone_number": "626-357-3258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ ROLON",
        "first_name": "TRACY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-09",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW109669",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "ASW109669",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW129816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.