| CASE NUMBER | I-200-24338-515311 |
| CASE STATUS | Certified |
| RECEIVED DATE | 12/3/2024 |
| DECISION DATE | 12/10/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Sr. Web Application Developer |
| SOC CODE | 15-1252.00 |
| SOC TITLE | Software Developers |
| FULL TIME POSITION | Y |
| BEGIN DATE | 6/1/2025 |
| END DATE | 5/31/2028 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 1 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | Commission on Medical Care |
| TRADE NAME DBA | Partnership HealthPlan of California |
| EMPLOYER ADDRESS1 | 4665 Business Center Drive |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Fairfield |
| EMPLOYER STATE | CA |
| EMPLOYER POSTAL CODE | 94534 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 17078634100 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 621111 |
| EMPLOYER POC LAST NAME | Mangabay |
| EMPLOYER POC FIRST NAME | Tammy |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | HR Manager |
| EMPLOYER POC ADDRESS1 | 4665 Business Center Drive |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Fairfield |
| EMPLOYER POC STATE | CA |
| EMPLOYER POC POSTAL CODE | 94534 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 17078634244 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | tmangabay@partnershiphp.org |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Wu |
| AGENT ATTORNEY FIRST NAME | Clifton |
| AGENT ATTORNEY MIDDLE NAME | Chia |
| AGENT ATTORNEY ADDRESS1 | 3590 North First Street |
| AGENT ATTORNEY ADDRESS2 | Suite 310 |
| AGENT ATTORNEY CITY | San Jose |
| AGENT ATTORNEY STATE | CA |
| AGENT ATTORNEY POSTAL CODE | 95134 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 14084329200 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | olivia@immigrationlawgroup.net |
| LAWFIRM NAME BUSINESS NAME | Immigration Law Group LLP |
| STATE OF HIGHEST COURT | CA |
| NAME OF HIGHEST STATE COURT | Supreme Court of California |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 4665 Business Center Drive |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Fairfield |
| WORKSITE COUNTY | SOLANO |
| WORKSITE STATE | CA |
| WORKSITE POSTAL CODE | 94534 |
| WAGE RATE OF PAY FROM | $159,286.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | $189,622.00 |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $159,286.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | IV |
| PW OES YEAR | 7/1/2024 - 6/30/2025 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| TOTAL WORKSITE LOCATIONS | 2 |
| 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 | Jang |
| PREPARER FIRST NAME | Olivia |
| PREPARER MIDDLE INITIAL | P |
| PREPARER BUSINESS NAME | Immigration Law Group LLP |
| PREPARER EMAIL | olivia@immigrationlawgroup.net |
| BEGIN DATE CONVERTED | 2025-06-01 |