| CASE NUMBER | I-200-25003-592410 |
| CASE STATUS | Certified |
| RECEIVED DATE | 1/3/2025 |
| DECISION DATE | 1/13/2025 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Dentist |
| SOC CODE | 29-1021.00 |
| SOC TITLE | Dentists, General |
| FULL TIME POSITION | Y |
| BEGIN DATE | 1/13/2025 |
| END DATE | 1/12/2028 |
| 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 | Bay Area Community Health |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 40910 Fremont Blvd. |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Fremont |
| EMPLOYER STATE | CA |
| EMPLOYER POSTAL CODE | 94538 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 15107708133 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 62111 |
| EMPLOYER POC LAST NAME | Robledo |
| EMPLOYER POC FIRST NAME | Ana |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Business Associate III |
| EMPLOYER POC ADDRESS1 | 40910 Fremont Blvd. |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Fremont |
| EMPLOYER POC STATE | CA |
| EMPLOYER POC POSTAL CODE | 94538 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 14085986040 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | arobledo@bach.health |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Kim |
| AGENT ATTORNEY FIRST NAME | Tommy |
| AGENT ATTORNEY MIDDLE NAME | |
| AGENT ATTORNEY ADDRESS1 | 640 E. Palisade Avenue |
| AGENT ATTORNEY ADDRESS2 | Suite 301 |
| AGENT ATTORNEY CITY | Englewood Cliffs |
| AGENT ATTORNEY STATE | NJ |
| AGENT ATTORNEY POSTAL CODE | 7632 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 18665261027 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | contact@judychanglaw.com |
| LAWFIRM NAME BUSINESS NAME | Judy Chang Law Firm |
| STATE OF HIGHEST COURT | NJ |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 9460 No Name Uno |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Gilroy |
| WORKSITE COUNTY | SANTA CLARA |
| WORKSITE STATE | CA |
| WORKSITE POSTAL CODE | 95020 |
| WAGE RATE OF PAY FROM | $136,000.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $99,840.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | I |
| PW OES YEAR | 7/1/2024 - 6/30/2025 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| TOTAL WORKSITE LOCATIONS | 1 |
| 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 | |
| PREPARER FIRST NAME | |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | |
| PREPARER EMAIL | |
| BEGIN DATE CONVERTED | 2025-01-13 |
