| LCA CASE NUMBER | I-200-21194-458901 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-07-13 |
| DECISION DATE | 2021-07-20 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Pediatrician |
| SOC CODE | 29-1065.00 |
| SOC TITLE | Pediatricians, General |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-10-24 |
| END DATE | 2024-10-23 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 1 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | LAKE COUNTY TRIBAL HEALTH CONSORTIUM, INC. |
| EMPLOYER ADDRESS1 | 925 BEVINS COURT |
| EMPLOYER CITY | Lakeport |
| EMPLOYER STATE | CA |
| EMPLOYER POSTAL CODE | 95453 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 17072638382 |
| NAICS CODE | 621498 |
| EMPLOYER POC LAST NAME | PADILLA |
| EMPLOYER POC FIRST NAME | Ernesto |
| EMPLOYER POC JOB TITLE | Chief Executive Officer |
| EMPLOYER POC ADDRESS1 | 925 Bevins Ct |
| EMPLOYER POC CITY | Lakeport |
| EMPLOYER POC STATE | CA |
| EMPLOYER POC POSTAL CODE | 95453 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 17072638382 |
| EMPLOYER POC EMAIL | EPADILLA@LCTHC.ORG |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Gauthier |
| AGENT ATTORNEY FIRST NAME | Grady |
| AGENT ATTORNEY ADDRESS1 | 250 N Main St, Ste G |
| AGENT ATTORNEY CITY | Fort Bragg |
| AGENT ATTORNEY STATE | CA |
| AGENT ATTORNEY POSTAL CODE | 95437 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 17074854458 |
| AGENT ATTORNEY EMAIL ADDRESS | ggauthier@ggauthierlaw.com |
| LAWFIRM NAME BUSINESS NAME | Law Office of Grady G Gauthier |
| STATE OF HIGHEST COURT | CA |
| NAME OF HIGHEST STATE COURT | SUPREME COURT |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 359 Lakeport Blvd. |
| LCA CASE WORKLOC1 CITY | Lakeport |
| WORKSITE COUNTY | LAKE |
| LCA CASE WORKLOC1 STATE | CA |
| WORKSITE POSTAL CODE | 95453 |
| LCA CASE WAGE RATE FROM | 275000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 170602 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2021 - 6/30/2022 |
| TOTAL WORKSITE LOCATIONS | 2 |
| AGREE TO LC STATEMENT | True |
| H-1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
