| LCA CASE NUMBER | I-200-20101-478582 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2020-04-10 |
| DECISION DATE | 2020-04-17 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Dentist |
| SOC CODE | 29-1021.00 |
| SOC TITLE | Dentists, General |
| FULL TIME POSITION | Y |
| LCA CASE EMPLOYMENT START DATE | 2020-10-01 |
| END DATE | 2023-09-30 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Mendocino Community Health Clinic, Inc. |
| EMPLOYER ADDRESS1 | 333 Laws Avenue |
| EMPLOYER CITY | Ukiah |
| EMPLOYER STATE | CA |
| EMPLOYER POSTAL CODE | 95482 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 17074681010 |
| NAICS CODE | 621111 |
| EMPLOYER POC LAST NAME | Damian |
| EMPLOYER POC FIRST NAME | Jill |
| EMPLOYER POC JOB TITLE | Chief Operating Officer, Interim CEO |
| EMPLOYER POC ADDRESS1 | 333 Laws Avenue |
| EMPLOYER POC CITY | Ukiah |
| EMPLOYER POC STATE | CA |
| EMPLOYER POC POSTAL CODE | 95482 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 17074724553 |
| EMPLOYER POC EMAIL | jdamian@mchcinc.org |
| AGENT REPRESENTING EMPLOYER | Y |
| AGENT ATTORNEY LAST NAME | Bach |
| AGENT ATTORNEY FIRST NAME | James |
| AGENT ATTORNEY MIDDLE NAME | Arnold |
| AGENT ATTORNEY ADDRESS1 | 100 Bush Street |
| AGENT ATTORNEY ADDRESS2 | Suite 1980 |
| AGENT ATTORNEY CITY | San Francisco |
| AGENT ATTORNEY STATE | CA |
| AGENT ATTORNEY POSTAL CODE | 94104 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 14152483100.0 |
| AGENT ATTORNEY EMAIL ADDRESS | jbach@immilaw.com |
| LAWFIRM NAME BUSINESS NAME | Law Offices of James A. Bach |
| STATE OF HIGHEST COURT | CA |
| NAME OF HIGHEST STATE COURT | California Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | N |
| WORKSITE ADDRESS1 | 333 Laws Avenue |
| LCA CASE WORKLOC1 CITY | Ukiah |
| WORKSITE COUNTY | MENDOCINO |
| LCA CASE WORKLOC1 STATE | CA |
| WORKSITE POSTAL CODE | 95482 |
| LCA CASE WAGE RATE FROM | 129029.0 |
| LCA CASE WAGE RATE TO | 137500.0 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 125029.0 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2019 - 6/30/2020 |
| TOTAL WORKSITE LOCATIONS | 3 |
| AGREE TO LC STATEMENT | Y |
| H-1B DEPENDENT | N |
| WILLFUL VIOLATOR | N |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Gardner (NS) |
| PREPARER FIRST NAME | Amanda |
| PREPARER MIDDLE INITIAL | J |
| PREPARER BUSINESS NAME | Law Offices of James A. Bach |
| PREPARER EMAIL | agardner@immilaw.com |
