# DR. JASON VON STIETZ

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1639995780
- **Gender:** Man

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TB0200X | Cognitive & Behavioral Psychologist | 33061 | CA | — |
| 103TC0700X | Clinical Psychologist | 33061 | CA | — |
| 103TE1100X | Exercise & Sports Psychologist | 33061 | CA | Yes |

## Other

- **Enumeration date:** 11/22/2024
- **Last updated:** 11/22/2024