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General NPI Number Information
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NPI Number | 1215866512
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Entity Type | Organization
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Legal Business Name | RADIANCE PSYCHOTHERAPY GROUP, APC
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Dates
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Enumeration Date | 05/14/2026
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Last Update Date | 05/14/2026
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Provider Practice Location Address
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Address Line | 5170 GOLDEN FOOTHILL PKWY
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City | EL DORADO HILLS
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State | CA
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Zip | 95762-9608
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Country | US
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Telephone | 916-234-3662
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Fax |
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Provider Business Mailing Address
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Address Line | 3941 PARK DR STE 20-403
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City | EL DORADO HILLS
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State | CA
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Zip | 95762-4549
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | DR. MATTHEW CHRISTOPHER BERGER
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Credential | PSYD
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Telephone | 916-234-3662
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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