Individual provider Active NPI

Rose Raksmie Om Hieng I, CASE MANAGER

  • Community Health Worker
  • Long Beach, CA
National Provider Identifier
1881945210
Registry record updated Oct 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
4510 E Pacific Coast Hwy Ste 600
Long Beach, CA 90804-6914
Phone
(562) 346-1100
Fax
(213) 383-3146
NPI assigned
Sep 25, 2012
Last updated
Oct 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Day Training/Habilitation Specialist 373H00000X CA
Community Health Worker 172V00000X Primary

Addresses

Primary practice location

4510 E Pacific Coast Hwy Ste 600
Long Beach, CA 90804-6914

Mailing address

4510 E Pacific Coast Hwy Ste 600
Long Beach, CA 90804-6914
Phone (562) 346-1100

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

Practice roles

OrganizationSpecialtyStatusNew patients
Special Service for Groups, Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1348531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759449600000",
    "number": "1881945210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4510 E PACIFIC COAST HWY STE 600",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908046914",
            "telephone_number": "562-346-1100",
            "fax_number": "213-383-3146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 E PACIFIC COAST HWY STE 600",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908046914",
            "telephone_number": "562-346-1100",
            "fax_number": "213-383-3146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OM HIENG",
        "first_name": "ROSE",
        "middle_name": "RAKSMIE",
        "name_suffix": "I",
        "credential": "CASE MANAGER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-25",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.