| CASE NUMBER | I-200-24332-503095 |
| CASE STATUS | Certified |
| RECEIVED DATE | 11/26/2024 |
| DECISION DATE | 12/4/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Family Medicine Physician |
| SOC CODE | 29-1215 |
| SOC TITLE | Family Medicine Physicians |
| FULL TIME POSITION | Y |
| BEGIN DATE | 1/6/2025 |
| END DATE | 1/5/2028 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 1 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | Livingston Community Health |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 600 B Street |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Livingston |
| EMPLOYER STATE | CA |
| EMPLOYER POSTAL CODE | 95334 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 12098503545 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 621498 |
| EMPLOYER POC LAST NAME | Abasta-Cummings |
| EMPLOYER POC FIRST NAME | Leslie |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Chief Executive Officer |
| EMPLOYER POC ADDRESS1 | 600 B Street |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Livingston |
| EMPLOYER POC STATE | CA |
| EMPLOYER POC POSTAL CODE | 95334 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 12098503545 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | lac@visitlch.org |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Hitz |
| AGENT ATTORNEY FIRST NAME | Alison |
| AGENT ATTORNEY MIDDLE NAME | P. |
| AGENT ATTORNEY ADDRESS1 | 505 Montgomery Street |
| AGENT ATTORNEY ADDRESS2 | Flr. 13th |
| AGENT ATTORNEY CITY | San Francisco |
| AGENT ATTORNEY STATE | CA |
| AGENT ATTORNEY POSTAL CODE | 94111 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 14159848563 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | ahitz@ClarkHill.com |
| LAWFIRM NAME BUSINESS NAME | Clark Hill PLC |
| STATE OF HIGHEST COURT | CA |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 600 B Street |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Livingston |
| WORKSITE COUNTY | MERCED |
| WORKSITE STATE | CA |
| WORKSITE POSTAL CODE | 95334 |
| WAGE RATE OF PAY FROM | $270,000.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $162,427.00 |
| 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 | 10 |
| 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 | Hitz |
| PREPARER FIRST NAME | Alison |
| PREPARER MIDDLE INITIAL | P. |
| PREPARER BUSINESS NAME | Clark Hill PLC |
| PREPARER EMAIL | ahitz@ClarkHill.com |
| BEGIN DATE CONVERTED | 2025-01-06 |
