| CASE NUMBER | I-200-24192-186377 |
| CASE STATUS | Certified |
| RECEIVED DATE | 7/10/2024 |
| DECISION DATE | 7/17/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Dentist Floater |
| SOC CODE | 29-1021.00 |
| SOC TITLE | Dentists, General |
| FULL TIME POSITION | Y |
| BEGIN DATE | 7/22/2024 |
| END DATE | 7/21/2027 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | St. John's Well Child and Family Center, Inc. |
| TRADE NAME DBA | St. John's Community Health |
| EMPLOYER ADDRESS1 | 808 W. 58th Street |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Los Angeles |
| EMPLOYER STATE | CA |
| EMPLOYER POSTAL CODE | 90037 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | +13235411600 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 6214 |
| EMPLOYER POC LAST NAME | Yamato |
| EMPLOYER POC FIRST NAME | Trisha |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Sr. Human Resources Director |
| EMPLOYER POC ADDRESS1 | 808 W. 58th Street |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Los Angeles |
| EMPLOYER POC STATE | CA |
| EMPLOYER POC POSTAL CODE | 90037 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | +13236844059 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | tyamato@sjch.org |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | IYER |
| AGENT ATTORNEY FIRST NAME | RAJKRISHNA |
| AGENT ATTORNEY MIDDLE NAME | Sriram |
| AGENT ATTORNEY ADDRESS1 | 21250 HAWTHORNE BLVD |
| AGENT ATTORNEY ADDRESS2 | STE. 160 E |
| AGENT ATTORNEY CITY | TORRANCE |
| AGENT ATTORNEY STATE | CA |
| AGENT ATTORNEY POSTAL CODE | 90503 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | +13103283322 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | raj@immigrationgc.com |
| LAWFIRM NAME BUSINESS NAME | Iyer Demirovic Chinchoy LLP |
| STATE OF HIGHEST COURT | CA |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 6505 8th Ave |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Los Angeles |
| WORKSITE COUNTY | LOS ANGELES |
| WORKSITE STATE | CA |
| WORKSITE POSTAL CODE | 90043 |
| WAGE RATE OF PAY FROM | 180,000.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $135,387.00 |
| PW UNIT OF PAY | Year |
| 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 | 6 |
| 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 Employment |
| PREPARER LAST NAME | |
| PREPARER FIRST NAME | |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | |
| PREPARER EMAIL | |
| BEGIN DATE CONVERTED | 2025-10-07 |
