Organization
FITNESS360
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE BURBOA (CEO)
(805) 607-9515
Entity
Organization
Contact information
Practice address
1317 DEL NORTE RD STE 220A, CAMARILLO, CA 93010-8621
(805) 607-9515
Mailing address
1574 TAMARIX ST, CAMARILLO, CA 93010-1945
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
—
—
133N00000X
Nutritionist
—
—
207K00000X
Allergy & Immunology Physician
—
—
207KA0200X
Allergy Physician
—
—
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
Primary
—
—
2083P0901X
Public Health & General Preventive Medicine Physician
—
—
Other
Enumeration date
04/02/2025
Last updated
04/24/2026
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