Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Derrick Coedno Cabico

Individual provider Registered Dietetic Technician · NPI 1558943597

Derrick Coedno Cabico is a Registered Dietetic Technician in Menifee, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2021
Specialties on file
2

Practice location Address checks out

30394 Lamplighter Ln
Menifee, CA 92584-6933
Phone: (951) 500-2104
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietetic Technician (primary) Taxonomy 136A00000X · Licence 86254119 (CA)
Registered Dietetic Technician Taxonomy 136A00000X

Record details

NPI number1558943597
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 27, 2021
Last updated in NPPESApril 27, 2021
Certification dateApril 27, 2021
Mailing address30394 Lamplighter Ln, Menifee, CA 92584-6933