| CASE NUMBER | I-200-24201-210502 |
| CASE STATUS | Certified |
| RECEIVED DATE | 7/19/2024 |
| DECISION DATE | 7/26/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Optometrist |
| SOC CODE | 29-1041.00 |
| SOC TITLE | Optometrists |
| FULL TIME POSITION | N |
| BEGIN DATE | 10/1/2024 |
| END DATE | 9/30/2027 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 1 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | UCSF MEDICAL CENTER |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 654 Minnesota Street |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | San Francisco |
| EMPLOYER STATE | CA |
| EMPLOYER POSTAL CODE | 94143 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | +14153534627 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Diehl |
| EMPLOYER POC FIRST NAME | Sylvia |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | HR Employment Supervisor |
| EMPLOYER POC ADDRESS1 | 654 Minnesota Street |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | San Francisco |
| EMPLOYER POC STATE | CA |
| EMPLOYER POC POSTAL CODE | 94143 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | +14153534627 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | sylvia.diehl@ucsf.edu |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Shih |
| AGENT ATTORNEY FIRST NAME | Jennifer |
| AGENT ATTORNEY MIDDLE NAME | |
| AGENT ATTORNEY ADDRESS1 | 360 Post St |
| AGENT ATTORNEY ADDRESS2 | Suite 800 |
| AGENT ATTORNEY CITY | San Francisco |
| AGENT ATTORNEY STATE | CA |
| AGENT ATTORNEY POSTAL CODE | 94108 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | +14159813000 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | jshih@vblaw.com |
| LAWFIRM NAME BUSINESS NAME | Van Der Hout LLP |
| STATE OF HIGHEST COURT | NY |
| NAME OF HIGHEST STATE COURT | NEW YORK COURT OF APPEALS |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 490 Illinois Street |
| WORKSITE ADDRESS2 | 4th floor |
| WORKSITE CITY | San Francisco |
| WORKSITE COUNTY | SAN FRANCISCO |
| WORKSITE STATE | CA |
| WORKSITE POSTAL CODE | 94158 |
| WAGE RATE OF PAY FROM | 70.04 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Hour |
| PREVAILING WAGE | $64.63 |
| PW UNIT OF PAY | Hour |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2024 - 6/30/2025 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| TOTAL WORKSITE LOCATIONS | 3 |
| AGREE TO LC STATEMENT | Yes |
| H 1B DEPENDENT | No |
| WILLFUL VIOLATOR | No |
| SUPPORT H1B | N/A |
| STATUTORY BASIS | |
| APPENDIX A ATTACHED | N/A |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Lam |
| PREPARER FIRST NAME | Tracey |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | Van Der Hout LLP |
| PREPARER EMAIL | tlam@vblaw.com |
| BEGIN DATE CONVERTED | 2024-01-10 |
