Nicolle Alexa Gamboa

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

55 Country Wood Dr
Pomona, CA 91766-4819

Phone

(909) 635-4892

NPI assigned

Mar 13, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1520899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769558400000",
    "number": "1396248696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 E FOOTHILL BLVD",
            "city": "AZUSA",
            "state": "CA",
            "postal_code": "917022606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 COUNTRY WOOD DR",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917664819",
            "telephone_number": "909-635-4892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBOA",
        "first_name": "NICOLLE",
        "middle_name": "ALEXA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-13",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Conor Berky Galvin
• Kevin Gamage, M.D.
• Alexa Gamboa Cabrera
• Judith Gamboa
• Marlene Gamboa, ACSW
• Natalie Gamero
• Anthony Gan
• Carol Lynn Gandolfo, PSY D
• Kimiya Sara Ganjooi
• Guangqiang Gao, M.D

• Athletic Trainer in Pomona, CA
• Providers in Pomona, CA by specialty
• Athletic Trainer in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.