MEDICARE: MOSAIC BEHAVIORAL CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency
2	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1376412288
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOSAIC BEHAVIORAL CARE LLC

Provider Business Mailing Address
First Line	:	11330 ELKWOOD ST
Second Line	:
City	:	SUN VALLEY
State	:	CA
Zip	:	91352-4439
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 S SEPULVEDA BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90049-3540
Country	:	US
Telephone Number	:	323-303-6078
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ANGEL GONZALEZ
Credential	:	BCBA
Telephone Number	:	323-303-6078

Provider Enumeration Date	:	10/30/2025
Last Update Date	:	02/16/2026

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