Provider Demographics
NPI:1568558351
Name:TILDEN, ROBIN L (RN)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:L
Last Name:TILDEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:18826 ROSITA STREET
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356
Mailing Address - Country:US
Mailing Address - Phone:818-881-8814
Mailing Address - Fax:
Practice Address - Street 1:1200 W HILLCREST DR
Practice Address - Street 2:STE. 100
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91320-2734
Practice Address - Country:US
Practice Address - Phone:805-963-2445
Practice Address - Fax:805-965-2292
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA510485363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA510485OtherRN