Genderlab, Inc.

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

Legal business name

GENDERLAB, INC.

Doing business as

GenderLab

Practice address

2043 California 2
Wrightwood, CA 92397-3274

Phone

(310) 606-1905

NPI assigned

Oct 20, 2021

Last updated

Nov 9, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

James Jasper Grimm

Title

Ceo

Phone

(310) 606-1905

Specialties & licenses 5

Addresses

Other names 1

• GenderLab Doing business as

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

{
    "created_epoch": "1634688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699488000000",
    "number": "1104589738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3274",
            "city": "WRIGHTWOOD",
            "state": "CA",
            "postal_code": "923973274",
            "telephone_number": "310-606-1905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2043 CALIFORNIA 2",
            "city": "WRIGHTWOOD",
            "state": "CA",
            "postal_code": "923973274",
            "telephone_number": "310-606-1905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENDERLAB, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-20",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A",
        "authorized_official_last_name": "GRIMM",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "JASPER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-606-1905"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GenderLab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mayna Chau, D.D.S.
• Csa 56 Wrightwood
• William R Fiorella, L.AC
• Jauregui Wrightwood Chiropractic Care, Inc
• Mario Albert Jauregui, D.C.
• Meaghan Martin Licensed Clinicial Social Worker Corporation
• Betty Omlor, LMFT
• Catherine Saldana, M.A.

• Endocrinology, Diabetes & Metabolism Physician in Wrightwood, CA
• Providers in Wrightwood, CA by specialty
• Endocrinology, Diabetes & Metabolism Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; 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.