Individual ProviderElijah Aaron MackeySocial WorkerBehavioral Health & Social Service ProvidersPractice Address160 E Virginia St Ste 280, San Jose, CA 95112-5817(408) 287-6200(408) 472-8524PECOS EnrollmentBased on the most recent information from CMS, provider Elijah Aaron Mackey does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1497348767Provider TypeIndividualFull NameMackey, Elijah AaronTitleMr.GenderMaleSole ProprietorYesEnumeration Date2/17/2021Last Updated7/16/2025Contact InformationPractice LocationPractice Address160 E Virginia St Ste 280, San Jose, CA 95112-5817Phone(408) 287-6200FaxUnlisted FaxMailing LocationMailing Address996 S 7th St, San Jose, CA 95112-3929Phone(408) 472-8524FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode104100000XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense131782CaliforniaCode171M00000XDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted IssuerCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer