Organization
GENDERLAB, INC.
Active
Other names
GenderLab
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES JASPER GRIMM (CEO)
(310) 606-1905
Entity
Organization
Contact information
Practice address
2043 CALIFORNIA 2, WRIGHTWOOD, CA 92397-3274
(310) 606-1905
Mailing address
PO BOX 3274, WRIGHTWOOD, CA 92397-3274
(310) 606-1905
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
163W00000X
Registered Nurse
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
10/20/2021
Last updated
11/09/2023
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