Healthcare Provider Details

I. General information

NPI: 1154254605
Provider Name (Legal Business Name): ROBERT GILDEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

708 S MILLER ST
SANTA MARIA CA
93454-6230
US

IV. Provider business mailing address

5619 AIDAN WAY
SANTA MARIA CA
93455-2829
US

V. Phone/Fax

Practice location:
  • Phone: 805-928-1783
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: