Provider Demographics
NPI:1457127862
Name:ISSUE INC.
Entity Type:Organization
Organization Name:ISSUE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAN-WILLEM
Authorized Official - Middle Name:
Authorized Official - Last Name:DIKKERS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT #139619
Authorized Official - Phone:310-990-4908
Mailing Address - Street 1:841 SAYRE LN
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90026-6206
Mailing Address - Country:US
Mailing Address - Phone:310-990-4908
Mailing Address - Fax:
Practice Address - Street 1:841 SAYRE LN
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-6206
Practice Address - Country:US
Practice Address - Phone:310-990-4908
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)