Organization Active NPI

Fitness360

  • Allergy & Immunology (Internal Medicine) Physician
  • Camarillo, CA
National Provider Identifier
1205630852
Registry record updated Apr 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology (Internal Medicine) PhysicianTaxonomy code 207RA0201X
Legal business name
FITNESS360
Practice address
1317 Del Norte Rd Ste 220a
Camarillo, CA 93010-8621
Phone
(805) 607-9515
NPI assigned
Apr 2, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2026

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

Authorized official

Name
Nicole Burboa
Title
Ceo
Phone
(805) 607-9515

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NN1001X
NutritionistGroup: 193200000X MULTI-SPECIALTY GROUP 133N00000X
Allergy & Immunology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207K00000X
Allergy PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207KA0200X
Allergy & Immunology (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RA0201X Primary
Public Health & General Preventive Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083P0901X

Addresses

Primary practice location

1317 Del Norte Rd Ste 220a
Camarillo, CA 93010-8621

Mailing address

1574 Tamarix St
Camarillo, CA 93010-1945

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1743552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776988800000",
    "number": "1205630852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1574 TAMARIX ST",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930101945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 DEL NORTE RD STE 220A",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930108621",
            "telephone_number": "805-607-9515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FITNESS360",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-02",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A",
        "authorized_official_last_name": "BURBOA",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "805-607-9515"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Nutrition",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207KA0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology, Allergy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RA0201X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camarillo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2026; 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.