Healthcare Provider Details

I. General information

NPI: 1215866512
Provider Name (Legal Business Name): RADIANCE PSYCHOTHERAPY GROUP, APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5170 GOLDEN FOOTHILL PKWY
EL DORADO HILLS CA
95762-9608
US

IV. Provider business mailing address

3941 PARK DR STE 20-403
EL DORADO HILLS CA
95762-4549
US

V. Phone/Fax

Practice location:
  • Phone: 916-234-3662
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. MATTHEW CHRISTOPHER BERGER
Title or Position: CFO
Credential: PSYD
Phone: 916-234-3662