| LCA CASE NUMBER | I-200-21076-154874 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-03-17 |
| DECISION DATE | 2021-03-24 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Family Medicine Physician |
| SOC CODE | 29-1062.00 |
| SOC TITLE | Family and General Practitioners |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-07-01 |
| END DATE | 2024-06-30 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 1 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Physicians' Network Medical Group, Inc. |
| EMPLOYER ADDRESS1 | One Adventist Health Way |
| EMPLOYER CITY | Roseville |
| EMPLOYER STATE | CA |
| EMPLOYER POSTAL CODE | 95661 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 19164060082 |
| NAICS CODE | 62111 |
| EMPLOYER POC LAST NAME | Drizen |
| EMPLOYER POC FIRST NAME | Kim |
| EMPLOYER POC JOB TITLE | Human Performance Director |
| EMPLOYER POC ADDRESS 1 | One Adventist Health Way |
| EMPLOYER POC CITY | Roseville |
| EMPLOYER POC STATE | CA |
| EMPLOYER POC POSTAL CODE | 95661 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 19164060082 |
| EMPLOYER POC EMAIL | drizenkm@ah.org |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Kelly |
| AGENT ATTORNEY FIRST NAME | Dayna |
| AGENT ATTORNEY MIDDLE NAME | Jo |
| AGENT ATTORNEY ADDRESS1 | 250 E. Winmore Ave |
| AGENT ATTORNEY CITY | Chapel Hill |
| AGENT ATTORNEY STATE | NC |
| AGENT ATTORNEY POSTAL CODE | 27516 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 19199697200 |
| AGENT ATTORNEY EMAIL ADDRESS | INFO@DKELLY.COM |
| LAWFIRM NAME BUSINESS NAME | Law Offices of Dayna Kelly, PC |
| STATE OF HIGHEST COURT | NC |
| NAME OF HIGHEST STATE COURT | Supreme Court |
|
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 1215 Plumas Street |
| WORKSITE ADDRESS2 | Ste 800 |
| LCA CASE WORKLOC1 CITY | Yuba City |
| WORKSITE COUNTY | SUTTER |
| LCA CASE WORKLOC1 STATE | CA |
| WORKSITE POSTAL CODE | 95991 |
| LCA CASE WAGE RATE FROM | 180619 |
| LCA CASE WAGE RATE TO | 376509 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 180049 |
| PW UNIT OF PAY | Year |
| PW OTHER SOURCE | Survey |
| PW OTHER YEAR | 2020 |
| PW SURVEY PUBLISHER | Medical Group Management Association |
| PW SURVEY NAME | MGMA: Provider Placement Starting Salary Report |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
