Individual provider Active NPI

Connie A. Robledo, FNP-BC

  • Family Nurse Practitioner
  • Northridge, CA
National Provider Identifier
1932617156
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95008362 Issued in CA
Practice address
8510 Balboa Blvd
Northridge, CA 91325-3583
Phone
(818) 455-9914
NPI assigned
Jan 22, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11020005 FL
Family Nurse Practitioner 363LF0000X 95008362 CA Primary

Addresses

Primary practice location

8510 Balboa Blvd
Northridge, CA 91325-3583

Mailing address

PO Box 925
Norco, CA 92860-0925
Phone (951) 729-9016

Other practice location 1

200 Oceangate
#100
Long Beach, CA 90802-4317
Phone (888) 562-5442

Other practice location 2

632 Broadway Ph
New York, NY 10012-2614
Phone (800) 731-4254

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180301002632 CA Practitioner - Nurse Practitioner 0345501664 Reassigns benefits to 3 organizations
I20211203002426 WA Practitioner - Nurse Practitioner 0345501664 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11020005FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Health Plan of California, Inc. CurrentSince Oct 4, 2024 Accepting new patients
Lakeside Medical Organization, a Medical Group Inc. CurrentSince Aug 9, 2025 Accepting new patients
Molina Healthcare of Washington, Inc Current Accepting new patients
Molina Healthcare of Washington, Inc CurrentSince Nov 23, 2021 Accepting new patients
Universal Care CurrentSince Oct 4, 2024 Accepting new patients
Lakeside Medical Associates, a Medical Group, Inc. Past Accepting new patients

Locations

191 S Buena Vista St
Ste 200
Burbank, CA 91505
Phone (818) 887-2671

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

8510 Balboa Blvd
Ste 150
Northridge, CA 91325
Phone (818) 637-2000

15 SW Everett Mall Way
Ste A
Everett, WA 98204
Phone (425) 348-6727

Interoperability endpoints

  • Direct secure messaging: connie.robledo.p1@direct.lakeside.nextgenshare.com

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1516579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1932617156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 925",
            "city": "NORCO",
            "state": "CA",
            "postal_code": "928600925",
            "telephone_number": "951-729-9016",
            "fax_number": "562-499-6171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8510 BALBOA BLVD",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913253583",
            "telephone_number": "818-455-9914"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Oceangate",
            "address_2": "#100",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908024317",
            "country_code": "US",
            "telephone_number": "888-562-5442",
            "fax_number": "562-499-6171",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "632 Broadway Ph",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100122614",
            "country_code": "US",
            "telephone_number": "800-731-4254",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBLEDO",
        "first_name": "CONNIE",
        "middle_name": "A.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-22",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11020005",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95008362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

Verify at the official NPI Registry.